Brandon C Mickelsen, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O-0450 Issued in ID

Practice address

1951 Bench Rd
Suite B
Pocatello, ID 83201-2073

Phone

(208) 238-1000

Fax

(208) 238-0009

NPI assigned

Jul 4, 2006

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 ID

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

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Practice Group, P.a.Group PAC ID 1658275391, shared by 2 NPIs, 14 clinicians

Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Symbii Home Health Home health agency, Chubbuck, ID, CCN 137110
• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.mickelsen.1@16258.direct.athenahealth.com

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.

• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Preston, ID
  • NPI 1033595541
  Medicare reassignment Care Compare group NPD
• Family Practice Group, P.a.

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1205869310
  Medicare reassignment NPD
• Family Practice Group, P.a.

  • Cardiac Rehabilitation Clinic/Center
  • Pocatello, ID
  • NPI 1912723214
  Medicare reassignment NPD
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1689802852
  Medicare reassignment NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, ID
  • NPI 1295734796

  Family Medicine

  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Downey, ID
  • NPI 1588666945

  Family Medicine

  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • American Falls, ID
  • NPI 1629077235

  Family Medicine

  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1942772223

  Family Medicine

  NPD
• Pocatello Health Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
  • NPI 1154089126
  NPD
• Pocatello Health Services, LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1215165485
  NPD
• Pocatello Hospital LLC

  • Internal Medicine Physician
  • Pocatello, ID
  • NPI 1760610935
  NPD

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

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation
• Whitewater Healthcare LLC

  • Home Health Agency
  • Chubbuck, ID
  • NPI 1477177921
  Care Compare affiliation

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1417987686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-238-1000",
            "fax_number": "208-238-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 BENCH RD",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012073",
            "telephone_number": "208-238-1000",
            "fax_number": "208-238-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSEN",
        "first_name": "BRANDON",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J. Gregson, M.D., P.a.
• Michael R Flandro OD PA
• Michael T McHugh D.D.S., PA
• Michael T. Callaghan M.D. & Associates, P.a.
• Amber Mickelsen
• Jennifer Miesch, PHD
• Mariette Milbrandt, CCC-SLP
• Carol Milder, NP
• Miles Counseling LLC
• James Miles, PHARMD

• Family Medicine Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.