Deborah Kim Mielke, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28770 Issued in MN

Practice address

409 N. Dunlap St.
Open Cities Health Center
St. Paul, MN 55104

Phone

(651) 290-9200

Fax

(651) 290-9201

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1326230293
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • St. Paul, MN
  • NPI 1225101405
  NPD (past)
• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1538037619
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1184692279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N. DUNLAP STREET",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N. DUNLAP ST.",
            "address_2": "OPEN CITIES HEALTH CENTER",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELKE",
        "first_name": "DEBORAH",
        "middle_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "28770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341875800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Innovative Neurodiagnostics LLP
• Midwest Medical Holdings LLC
• Midwest Medical Holdings LLC
• Midwest Radiology Outpatient Imaging, LLC
• Midwest Stabilization Services Inc
• Matthew Lester Mielke, M.D.
• Mietus NP Mental Health, LLC
• Stacey Thompson Mietus, APRN, CNP
• Travis Nelson Mighell, APRN, CRNA
• Mighty Oak Chiropractic, PLLC

• Family Medicine Physician in St. Paul, MN
• Providers in St. Paul, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.

Verify at the official NPI Registry.