Individual provider Active NPI

Mikah Caldwell Owen, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1174886238
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A127077 Issued in CA
Practice address
2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone
(916) 734-5177
NPI assigned
Jun 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A127077 CA Primary

Addresses

Primary practice location

2516 Stockton Blvd
Sacramento, CA 95817-2208

Mailing address

2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone (916) 734-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150916000495 FL Practitioner - Pediatric Medicine 0042527525 Reassigns benefits to 2 organizations
I20200409001368 CA Practitioner - Pediatric Medicine 0042527525 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A127077CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Pediatrics CurrentSince Jul 1, 2015 Accepting new patients
County of Sacramento CurrentSince May 1, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince May 1, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Im Sulzbacher Center for the Homeless, Inc CurrentSince Jun 3, 2019 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
County of Sacramento CurrentSince May 1, 2020 Accepting new patients
Im Sulzbacher Center for the Homeless, Inc Pediatrics CurrentSince Jun 3, 2019 Accepting new patients
Sacramento Native American Health Center Inc CurrentSince Oct 1, 2020 Accepting new patients
Regents of the University of Ca Pediatrics CurrentSince May 1, 2020 Accepting new patients

Locations

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

2020 J St
Sacramento, CA 95811
Phone (916) 341-0575

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

515 W 6th St
Jacksonville, FL 32206
Phone (904) 253-1040

611 E Adams St
Jacksonville, FL 32202
Phone (904) 359-0457

850 6th Ave S
Ste 500
Jacksonville Beach, FL 32250
Phone (904) 224-3550

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mowen309682@direct.ochin.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1174886238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MIKAH",
        "middle_name": "CALDWELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A127077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.