James L Mikkelsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2554T Issued in TX

Practice address

3405 Spencer Hwy
Pasadena, TX 77504-1107

Phone

(281) 875-2020

NPI assigned

Feb 22, 2006

Last updated

Nov 23, 2021By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Pasadena, TX
  • NPI 1235800368
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Northline Tso PC

  dba Northline Texas State Optical

  • Optometrist
  • Houston, TX
  • NPI 1134198518
  NPD (past)
• Northshore Tso, Inc.

  • Optometrist
  • Houston, TX
  • NPI 1639148034
  NPD (past)
• PNZ Place Tso PC

  dba Pennzoil Texas State Optical

  • Optometrist
  • Houston, TX
  • NPI 1972572378
  NPD (past)
• Tomball Texas State Optical PA

  • Optometrist
  • Tomball, TX
  • NPI 1770552176
  NPD (past)
• Willowbrook Tso PC

  dba Willowbrook Texas State Optical

  • Optometrist
  • Houston, TX
  • NPI 1073582466
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1265407373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 SPENCER HWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041107",
            "telephone_number": "281-875-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2554T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548190-04",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548190-06",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11616014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amir Shabbir Mian, MD
• Salman Mian, MD
• Yu Miao
• Michael Nugent DDS PC
• William Daniel Middleton, D.D.S.
• Chess Lynnette Miles, D.C.
• Bart Miller
• Bruce Miller, DPM
• Earl L Miller Jr., M.D.
• Eric Robert Miller, M.A CCC-SLP

• Optometrist in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.