Individual provider Active NPI

Paul M. Mikus II, M.D.

  • Internal Medicine Physician
  • Largo, FL
National Provider Identifier
1356363196
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME98180 Issued in FL
Practice address
8787 Bryan Dairy Rd
Suite 275
Largo, FL 33777-1260
Phone
(727) 394-5650
Fax
(813) 635-7939
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME98180 FL Primary
Pediatrics Physician 208000000X ME98180 FL

Addresses

Primary practice location

8787 Bryan Dairy Rd
Suite 275
Largo, FL 33777-1260

Mailing address

PO Box 743409
Atlanta, GA 30374-3409
Phone (727) 532-0002

Other identifiers 2

IdentifierTypeStateIssuer
P00451227OtherFLRAILROAD MEDICARE
278900100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME98180FLMDInternal Medicine Physician
189398NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group Pediatric Walk-in, LLC Pediatrics Past Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Pediatrics Past Accepting new patients

Organizations & group practices 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1356363196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8787 BRYAN DAIRY RD",
            "address_2": "SUITE 275",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337771260",
            "telephone_number": "727-394-5650",
            "fax_number": "813-635-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKUS",
        "first_name": "PAUL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME98180",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00451227",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278900100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.