Individual provider Active NPI

Robert A. Mikan, M.D.

  • Pediatrics Physician
  • Indianapolis, IN
National Provider Identifier
1316385859
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
11017273A Issued in IN
Practice address
705 Riley Hospital Dr
Room 5867
Indianapolis, IN 46202-5109
Phone
(317) 944-4034
Fax
(317) 944-1476
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11017273A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Room 5867
Indianapolis, IN 46202-5109

Mailing address

531 Virginia Ave
Unit 106
Indianapolis, IN 46203-1790
Phone (937) 581-8489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130913000063 IN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4587808514

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. Pediatrics Past Accepting new patients

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1316385859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 VIRGINIA AVE",
            "address_2": "UNIT 106",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462031790",
            "telephone_number": "937-581-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "ROOM 5867",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-4034",
            "fax_number": "317-944-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKAN",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "11017273A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.