Carl Terence Mickman, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

294040 Issued in NY

Practice address

1 Gustave L Levy PL
Box 1149
New York, NY 10029-6504

Phone

(612) 618-7945

NPI assigned

Mar 26, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, VI, LA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

Louisiana State University School of Medicine in New Orleans, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Emergency Medicine Management -- Lake Charles LLCGroup PAC ID 7012131378, 19 clinicians

Louisiana State University School of Medicine in New Orleans FacultyGroup PAC ID 9638459613, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center New Orleans Hospital, New Orleans, LA, CCN 190005
• Lallie Kemp Medical Center Hospital, Independence, LA, CCN 191321

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmickman5287341@direct.casso.us.com
• Direct secure messaging: carlmickman@mai.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Louisiana State University School of Medicine in New Orleans Faculty

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1275984973
  Medicare reassignment Care Compare group NPD
• Professional Emergency Medicine Management -- Lake Charles LLC

  • Emergency Medicine Physician
  • Lake Charles, LA
  • NPI 1023430766
  Medicare reassignment Care Compare group NPD
• Belle Chasse Emergency Group LLC

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1851714075
  Medicare reassignment NPD
• Children'S Hospital

  • Specialist
  • New Orleans, LA
  • NPI 1043230873

  Emergency Medicine

  Medicare reassignment NPD
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment NPD
• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment NPD
• Kenner Emergency Group LLC

  • Emergency Medicine Physician
  • Kenner, LA
  • NPI 1013986546
  Medicare reassignment NPD
• Luling Emergency Group LLC

  • Emergency Medicine Physician
  • Luling, LA
  • NPI 1528446101
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• PHS Indian Hospital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1508809765

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Riverside Emergency Physician Partners LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1083107080
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lallie Kemp Medical Center

  • General Acute Care Hospital
  • Independence, LA
  • NPI 1366767774
  Care Compare affiliation
• Lallie Kemp Medical Ctr

  • Critical Access Hospital
  • Independence, LA
  • NPI 1083661409
  Care Compare affiliation
• University Medical Center Management Corporation

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1568403111
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1124445242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "612-618-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "612-618-7945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N James St",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "NY",
            "postal_code": "134402844",
            "country_code": "US",
            "telephone_number": "315-338-7035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKMAN",
        "first_name": "CARL",
        "middle_name": "TERENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "326621",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "294040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa K. Mickel, LCSW
• Rachel Mickenberg, LCSW
• Natalie Mickhael, MD
• Nathan Keeler Mickinac, MD
• Molly Ann Mickle, FNP
• Jenika Miclat, RN
• Mark Luis Miclat, PT, DPT
• Mid Atlantic Medical P.C.
• Mid City TMS Psychiatric PLLC
• Mid-Atlantic Medical Services,PC

• Emergency Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.