Individual provider Active NPI

Brian Mikolasko, MD MBA MS

  • Internal Medicine Physician
  • Johnston, RI
National Provider Identifier
1346669512
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16379 Issued in RI
Practice address
2109 Hartford Ave
Johnston, RI 02919-3246
Phone
(626) 319-5932
Fax
(626) 380-2395
NPI assigned
Apr 15, 2014
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Internal Medicine Physician 207R00000X 463951 PA
Internal Medicine Physician 207R00000X 149352 CA
Internal Medicine Physician 207R00000X 276683 MA
Internal Medicine Physician 207R00000X 16379 RI Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 16379 RI

Addresses

Primary practice location

2109 Hartford Ave
Johnston, RI 02919-3246

Mailing address

2109 Hartford Ave
Johnston, RI 02919-3246
Phone (626) 319-5932

Other identifiers 2

IdentifierTypeStateIssuer
MD463951OtherPAPENNSYLVANIA STATE BOARD OF MEDICINE
A149352OtherCATHE MEDICAL BOARD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, PA, RI, MA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20171101001384 CA Practitioner - Internal Medicine 5496021768 Reassigns benefits to 1 organization
I20180618003338 PA Practitioner - HospitalistPractitioner - Internal Medicine 5496021768 Reassigns benefits to 1 organization
I20181126003221 RI Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 5496021768 Reassigns benefits to 2 organizations
I20190226002091 MA Practitioner - Internal Medicine 5496021768 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Lucas Medical LLCGroup PAC ID 2163958059, 2 clinicians

Practice addresses (Care Compare)

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4275

2109 Hartford Ave
Johnston, RI 02919-3246
Phone (401) 587-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
149352CAMDMarriage & Family Therapist
276683MAMDInternal Medicine Physician
463951PAMDInternal Medicine Physician
16379RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Feb 5, 2019 Accepting new patients
St Luke's Methodist Hospital General Acute Care Hospital Current Accepting new patients
Ava Health LLC Internal Medicine Current Accepting new patients
Lucas Medical LLC Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 1, 2018 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2023 Accepting new patients
Hospitalist Group of Montebello Inc CurrentSince Jun 1, 2024 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2023 Accepting new patients
Fairview Hospital Hospice and Palliative Medicine CurrentSince Jul 17, 2023 Accepting new patients
Physicians of Cape Cod Hospital Internal Medicine CurrentSince Sep 23, 2023 Accepting new patients
Hopehealth Hospice & Palliative Care CurrentSince Oct 1, 2018 Accepting new patients
Bella Health LLC Internal Medicine Current Accepting new patients
Hopehealth Hospice & Palliative Care CurrentSince Oct 1, 2018 Accepting new patients
Fairview Hospital CurrentSince Jul 17, 2023 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 1, 2018 Accepting new patients

Locations

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

75 Francis St
Boston, MA 02115

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

29 Lewis Ave
Gt Barrington, MA 01230
Phone (413) 528-0790

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

1 Nolte Dr
Kittanning, PA 16201
Phone (724) 543-8109

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

2109 Hartford Ave
Johnston, RI 02919
Phone (401) 587-1000

1085 N Main St
Providence, RI 02904
Phone (401) 415-4200

Interoperability endpoints

  • Direct secure messaging: bmikolasko916420@direct.unitypoint.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 10

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1346669512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193246",
            "telephone_number": "626-319-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193246",
            "telephone_number": "626-319-5932",
            "fax_number": "626-380-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLASKO",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD MBA MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "463951",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "149352",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "276683",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "16379",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "RI",
            "license": "16379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF MEDICINE",
            "identifier": "MD463951",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A149352",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.