Individual provider Active NPI

Alexander Thomas Mikulka, DO, MBS

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1225769912
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS21670 Issued in FL
Practice address
300 Parkview PL
Lakeland, FL 33805-4550
Phone
(863) 687-1300
NPI assigned
Jun 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS21670 FL Primary

Addresses

Primary practice location

300 Parkview PL
Lakeland, FL 33805-4550

Mailing address

300 Parkview PL
Lakeland, FL 33805-4550
Phone (863) 687-1300

Other practice location 1

4240 Lakeland Highlands Rd
Lakeland, FL 33813-3113
Phone (863) 646-8699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260320003647 FL Practitioner - Internal Medicine 7012491699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ballout International PLLCGroup PAC ID 5890045256, 48 clinicians

Practice addresses (Care Compare)

4240 Lakeland Highlands Rd
Lakeland, FL 33813-3113
Phone (321) 387-9451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS21670FLMDInternal Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1225769912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PARKVIEW PL",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054550",
            "telephone_number": "863-687-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARKVIEW PL",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054550",
            "telephone_number": "863-687-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Lakeland Highlands Rd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338133113",
            "country_code": "US",
            "telephone_number": "863-646-8699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKULKA",
        "first_name": "ALEXANDER",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO, MBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.