Ian Haskell Mikolaj, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24485 Issued in NV

Practice address

141 Keddie St
Fallon, NV 89406-2820

Phone

(775) 423-7141

NPI assigned

Mar 21, 2019

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 NV

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

Specialty

Psychiatry

Education

Saint Louis University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

State of NevadaGroup PAC ID 9234022153, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ely, NV
  • NPI 1760572010
  Medicare reassignment Care Compare group NPD
• State of Nevada

  • Skilled Nursing Facility
  • Boulder City, NV
  • NPI 1083612741
  NPD
• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Winnemucca, NV
  • NPI 1275623530
  NPD
• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Silver Springs, NV
  • NPI 1811079742
  NPD (past)

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

• Banner Churchill Community Hospital

  • Critical Access Hospital
  • Fallon, NV
  • NPI 1265811251
  Care Compare affiliation

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1417417015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5470 KIETZKE LANE",
            "address_2": "SUITE 300 PMB 350",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112099",
            "telephone_number": "775-284-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 KEDDIE ST",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062820",
            "telephone_number": "775-423-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAJ",
        "first_name": "IAN",
        "middle_name": "HASKELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "24485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Melendy, MS, MFT, LADC
• Audrea Mendiola
• Lacy Mae Menzies, MS MFT LADC, LADC-S
• Michael Lagrone
• Michelle Diedrichsen
• Maria M Miller, DA
• Michelle Marie Miller, O.D.
• Shannon Miller
• Dorothy Mitchell
• Jessica Mitchell

• Psychiatry Physician in Fallon, NV
• Providers in Fallon, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.