Individual provider Active NPI

Mina Mikhael

  • Ophthalmology Physician
  • Bronx, NY
National Provider Identifier
1205463213
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0100769 Issued in MD
Practice address
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 920-4321
NPI assigned
Mar 27, 2020
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0100769 MD Primary

Addresses

Primary practice location

111 East 210TH Street
Bronx, NY 10467

Mailing address

6201 Greenleigh Ave FL 2
Middle River, MD 21220-2004
Phone (410) 933-2704

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-8893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20251002000441 NJ Practitioner - Ophthalmology 5193261600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rutgers New Jersey Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Centers of America LLCGroup PAC ID 7315125184, 127 clinicians

Practice addresses (Care Compare)

195 Fairfield Ave
Suite 4B
West Caldwell, NJ 07006-6419
Phone (973) 228-4990

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0100769MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essex Eye Physicians LLC Ophthalmology CurrentSince Aug 18, 2025 Accepting new patients
Eye Centers of America, LLC Ophthalmology CurrentSince Aug 18, 2025 Accepting new patients

Locations

1255 Broad St
Ste 104
Bloomfield, NJ 07003
Phone (973) 707-5632

213 Park St
Montclair, NJ 07042
Phone (973) 220-7612

195 Fairfield Ave
Ste 4B
West Caldwell, NJ 07006
Phone (973) 228-4990

Interoperability endpoints

  • Direct secure messaging: mmikhael@ecoa.intellechartdirect.net

Organizations & group practices 2

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1205463213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE FL 2",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKHAEL",
        "first_name": "MINA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0100769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.