NPIMap

Individual provider Active NPI

John Mihailidis, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Neenah, WI
National Provider Identifier
1194036533
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
84089 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 358-1223
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 30557 NE
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 311791 NY
Student in an Organized Health Care Education/Training Program 390200000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 84089 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 358-1223

Other practice location 1

325 Essjay Rd
Williamsville, NY 14221-8243
Phone (716) 656-4468

Other practice location 2

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 656-4468

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com Buffalo Medical Group, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, NY, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180131000859 NE Practitioner - Endocrinology 3173843901 Reassigns benefits to 1 organization
I20220325001161 NY Practitioner - Endocrinology 3173843901 Reassigns benefits to 1 organization
I20240815004603 WI Practitioner - Endocrinology 3173843901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 725-0077

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311791NYMDEndocrinology, Diabetes & Metabolism Physician
84089WIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Endocrinology, Diabetes & Metabolism CurrentSince Apr 8, 2018 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Mar 17, 2022 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Mar 17, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Aug 3, 2024 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients

Locations

611 W Francis St
Ste 200
North Platte, NE 69101
Phone (308) 534-9230

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

3900 N Buffalo St
Orchard Park, NY 14127
Phone (716) 630-1112

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

325 Essjay Rd
Williamsville, NY 14221
Phone (716) 630-1102

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: production@direct.buffalomedicalgroup.com
  • Direct secure messaging: jmihailidis342932@direct.thedacare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1194036533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-358-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-358-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Essjay Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142218243",
            "country_code": "US",
            "telephone_number": "716-656-4468",
            "fax_number": "716-250-5941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "14127",
            "country_code": "US",
            "telephone_number": "716-656-4468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIHAILIDIS",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NE",
            "license": "30557",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "311791",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "84089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "Y",
            "affiliationName": "Buffalo Medical Group, P.C.",
            "address_1": "3900 N Buffalo St",
            "city": "Orchard Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.