Andrew Mirocke, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301115689 Issued in MI

Practice address

225 E Jackson Ave
Jonesboro, AR 72401-3119

Phone

(870) 207-4100

NPI assigned

Jun 15, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, KY, NC, TN4 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 4

Specialty

Emergency Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

West Fairview Emergency Physicians LLCGroup PAC ID 5799034799, 40 clinicians

Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Baptist Health Deaconess Medical Group IncGroup PAC ID 6103220330, 241 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
• Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002
• St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041
• Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093
• TJ Health Columbia Hospital, Columbia, KY, CCN 180149

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baptist Health Deaconess Medical Group Inc

  • Internal Medicine Physician
  • Madisonville, KY
  • NPI 1437730942
  Medicare reassignment Care Compare group NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, NC

  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment Care Compare group NPD
• West Fairview Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ashland, KY
  • NPI 1578060331
  Medicare reassignment Care Compare group NPD
• St Bernards Hospital Inc.

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1396053096
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Orthopaedic Surgery Physician
  • Fort Smith, AR
  • NPI 1699070649
  Medicare reassignment
• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment
• Eagle Creek Emergency Group, PC

  • Emergency Medicine Physician
  • Paris, TN
  • NPI 1134627557
  Medicare reassignment
• Baptist Health Deaconess Medical Group Inc

  • Rural Health Clinic/Center
  • Madisonville, KY
  • NPI 1144804311
  NPD
• Baptist Health Deaconess Medical Group Inc

  • Hospitalist Physician
  • Madisonville, KY
  • NPI 1972320430

  Emergency Medicine

  NPD

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

• Russellville Holdings LLC

  • General Acute Care Hospital
  • Russellville, AR
  • NPI 1033160049
  Care Compare affiliation
• Baptist Health Deaconess Madisonville Inc

  • Rural Acute Care Hospital
  • Madisonville, KY
  • NPI 1447231956
  Care Compare affiliation
• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation
• MH Mission Hospital, LLLP

  • General Acute Care Hospital
  • Asheville, NC
  • NPI 1962987677
  Care Compare affiliation
• T J Health Columbia Inc

  • General Acute Care Hospital
  • Columbia, KY
  • NPI 1134585656
  Care Compare affiliation

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1174017958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-207-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-207-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROCKE",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "58430",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301115689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracle Kids Success Academy, Inc.
• Miracle Kids Success Academy, Inc.
• Kayla Miranti
• Emily Madison Mireles
• Shayla Angelia Mireles, QBHP
• Sara Misner
• Anna Claire Mitchell, BCBA
• Audra Grace Mitchell, MCD CCC-SLP
• Brittany Danielle Mitchell, MCD, CCC-SLP
• Dawn Mitchell, LPC

• Emergency Medicine Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.