Mikal Kidder

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

093672 Issued in IA

Practice address

701 10TH St SE
Cedar Rapids, IA 52403-1251

Phone

(319) 398-6011

NPI assigned

Oct 1, 2018

Last updated

Oct 1, 2018By 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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  dba Liberty Elementary

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1659630457
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)
• Ihc Health Services Inc

  dba Ogden Cardiovascular

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ogden, UT
  • NPI 1962547695
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1376028845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031292",
            "telephone_number": "319-398-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "MIKAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "093672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keystone Place, LLC (Keystone Cedars)
• Amira Khalafalla
• Mohammed E Khalil, MD
• Sophia Raziuddin Khatri, OD
• Adnan N. Kiani, M.D
• Angela Lynn Kieffer, PMHNP
• Jill Kilkenny, PT
• Sunny R Kim, MD
• Jay Spencer Kimball, LMSW
• Caleb Kimm, DO

• Surgical Physician Assistant in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Surgical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.