Individual provider Active NPI

Dennis P Mihale, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1508025859
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME55169 Issued in FL
Practice address
7213 Ramoth Dr
Jacksonville, FL 32226-3200
Phone
(813) 494-6987
NPI assigned
Jun 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME55169 FL Primary

Addresses

Primary practice location

7213 Ramoth Dr
Jacksonville, FL 32226-3200

Mailing address

7213 Ramoth Dr
Jacksonville, FL 32226-3200
Phone (813) 494-6987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NJ, NY, GA, AZ5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20201106000683 MA Practitioner - Emergency Medicine 0547585481
I20210309001507 NJ Practitioner - Emergency Medicine 0547585481
I20210428001360 NY Practitioner - Emergency Medicine 0547585481 Reassigns benefits to 1 organization
I20210720000487 GA Practitioner - Emergency Medicine 0547585481
I20230512002002 AZ Practitioner - Emergency Medicine 0547585481 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME55169FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Mihale MD of Ny PC CurrentSince Apr 15, 2021 Accepting new patients
Upward Health of Arizona LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

80 Arkay Dr
Ste 230
Hauppauge, NY 11788
Phone (631) 540-8225

188 Valley St
Ste 201
Providence, RI 02909
Phone (401) 648-6200

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1508025859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 RAMOTH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322263200",
            "telephone_number": "813-494-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7213 RAMOTH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322263200",
            "telephone_number": "813-494-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHALE",
        "first_name": "DENNIS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-02",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME55169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.