NPIMap

Individual provider Active NPI

Alan Bart Mickish, M.D.

  • Family Medicine Physician
  • Eastland, TX
National Provider Identifier
1215045240
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E1059 Issued in TX
Practice address
400 W Plummer
Eastland, TX 76448
Phone
(254) 629-1744
Fax
(254) 629-3904
NPI assigned
Aug 29, 2006
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E1059 TX Primary

Addresses

Primary practice location

400 W Plummer
Eastland, TX 76448

Mailing address

PO Box 1429
Eastland, TX 76448-1429
Phone (254) 629-1744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000775 TX Practitioner - Family Practice 1052489093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
B and W Healthcare Associates PAGroup PAC ID 7416025457, 4 clinicians

Practice addresses (Care Compare)

400 W Plummer
Eastland, TX 76448-2627
Phone (254) 629-1744

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.35 of 100Reported as apm
Quality
58.35
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions38
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
B & W Healthcare Associates PA Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients
B & W Clinic PA Family Medicine PastSince Aug 1, 2008 Accepting new patients

Locations

400 W Plummer St
Eastland, TX 76448
Phone (254) 629-1744

Interoperability endpoints

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The WoodlandsEastland, TX, CCN 675001 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 8

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1215045240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1429",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "764481429",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PLUMMER",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "76448",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKISH",
        "first_name": "ALAN",
        "middle_name": "BART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastland, TX

Sources for this page

Verify at the official NPI Registry.