NPIMap

Individual provider Active NPI

Mark D Miceli, M.D.

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1184658858
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
W3284 Issued in TX
Practice address
921 Gessner Rd
Houston, TX 77024-2501
Phone
(713) 242-3768
Fax
(713) 984-6854
NPI assigned
Jul 10, 2006
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2017034370 MO
Psychiatry Physician 2084P0800X 25MA07643400 NJ
Psychiatry Physician 2084P0800X 64833 MN
Psychiatry Physician 2084P0800X 308-320 WI
Psychiatry Physician 2084P0800X W3284 TX Primary

Addresses

Primary practice location

921 Gessner Rd
Houston, TX 77024-2501

Mailing address

114 W 7TH St Ste 900
Austin, TX 78701-3013
Phone (512) 838-4264

Other practice location 1

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 262-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190306000240 MN Practitioner - Psychiatry 1951305036 Reassigns benefits to 1 organization
I20240926001670 MI Practitioner - Psychiatry 1951305036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
McLaren Northern MichiganGroup PAC ID 9931018181, 60 clinicians
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

1455 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (651) 635-9173

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

520 Osborne Rd NE
Fridley, MN 55432-2718

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone (763) 427-9980

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

800 E 28TH St
Minneapolis, MN 55407-3723

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.08
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2017034370MOMDPsychiatry Physician
25MA07643400NJMDPsychiatry Physician
308-320WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
McLaren Northern Michigan CurrentSince Sep 3, 2024 Accepting new patients
McLaren Northern Michigan CurrentSince Sep 3, 2024 Accepting new patients
Metropolitan Hospital Psychiatry CurrentSince Jan 1, 2026 Accepting new patients
Allina Health System CurrentSince Dec 17, 2018 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

748 S Main St
Cheboygan, MI 49721
Phone (231) 627-1289

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1184658858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W 7TH ST STE 900",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787013013",
            "telephone_number": "512-838-4264",
            "fax_number": "512-838-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GESSNER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242501",
            "telephone_number": "713-242-3768",
            "fax_number": "713-984-6854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "612-262-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICELI",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2017034370",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA07643400",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "64833",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "308-320",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "W3284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.