Individual provider Active NPI

Jessica Mikuliak, FNP

  • Family Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1174668909
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R139818 Issued in MD
Practice address
7987 Georgia Ave
Silver Spring, MD 20910-4838
Phone
(301) 557-1870
NPI assigned
Feb 20, 2007
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN67407 DC
Family Nurse Practitioner 363LF0000X R139818 MD Primary

Addresses

Primary practice location

7987 Georgia Ave
Silver Spring, MD 20910-4838

Mailing address

7987 Georgia Ave
Silver Spring, MD 20910-4838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080924000401 DC Practitioner - Nurse Practitioner 2860569498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services of Holy Cross CurrentSince Apr 1, 2020 Accepting new patients
Professional Services of Holy Cross CurrentSince Apr 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

201 Russell Ave
Gaithersburg, MD 20877
Phone (301) 216-4157

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

7987 Georgia Ave
Silver Spring, MD 20910
Phone (301) 557-1870

Interoperability endpoints

  • Direct secure messaging: jmikuliak1142695@direct.trinity-health.org

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1174668909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7987 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7987 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104838",
            "telephone_number": "301-557-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULIAK",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN67407",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R139818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.