Active NPI
Joel Mickail
- Physician Assistant
- Lake Jackson, TX
National Provider Identifier
1164742946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA06800
- Practice address
- 100 Medical Dr
Lake Jackson, TX 77566-5674 - Phone
- (979) 285-1984
- NPI assigned
- Jun 3, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA06800 | TX | Primary |
Addresses
Primary practice location
100 Medical Dr
Lake Jackson, TX 77566-5674
Mailing address
100 Medical Dr
Lake Jackson, TX 77566-5674
Phone (979) 285-1984
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA06800 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Health Centers | Past | Accepting new patients |
Interoperability endpoints
- joel.mickail.1@15750.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Gainesville, TX
- NPI 1538101019
-
- Emergency Medicine Physician
- Pasadena, TX
- NPI 1801458708
-
- Emergency Medicine Physician
- Austin, TX
- NPI 1962440933
-
- Internal Medicine Physician
- Cedar Park, TX
- NPI 1801300322
-
- General Acute Care Hospital
- Cypress, TX
- NPI 1629828405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279411200000",
"number": "1164742946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MEDICAL DR",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665674",
"telephone_number": "979-285-1984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEDICAL DR",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665674",
"telephone_number": "979-285-1984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKAIL",
"first_name": "JOEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2010-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA06800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Jackson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.