NPIMap

Individual provider Active NPI

Justin Paul Mikula, M.D.

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1508839614
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.084818 Issued in OH
Practice address
1615 N River Rd NE
Suite 1
Warren, OH 44483-2437
Phone
(330) 372-2333
Fax
(330) 373-1111
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.084818 OH Primary

Addresses

Primary practice location

1615 N River Rd NE
Suite 1
Warren, OH 44483-2437

Mailing address

1615 N River Rd NE
Suite 1
Warren, OH 44483-2437
Phone (330) 372-2333

Other identifiers 1

IdentifierTypeStateIssuer
2580434MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101000679 OH Practitioner - Internal Medicine 8426075185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Justin P. Mikula, M.D., Inc.Group PAC ID 9436176195, 2 clinicians

Practice addresses (Care Compare)

1615 N River Rd NE
Suite 1
Warren, OH 44483-2437
Phone (330) 372-2333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.084818OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince May 15, 2022 Accepting new patients
Justin P. Mikula, M.D., Inc. Internal Medicine CurrentSince Oct 10, 2005 Accepting new patients
Steward Medical Group Inc. Internal Medicine CurrentSince May 15, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Youngstown Ohio Physician Services Company LLC Internal Medicine Past Accepting new patients

Locations

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

1615 N River Rd NE
#1
Warren, OH 44483
Phone (330) 372-2333

1615 N River Rd NE
Warren, OH 44483
Phone (330) 372-2333

500 Gypsy Ln
Youngstown, OH 44504
Phone (330) 740-4572

Interoperability endpoints

  • Direct secure messaging: justin.mikula@10515.chartlogic.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1508839614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "address_2": "SUITE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437",
            "telephone_number": "330-372-2333",
            "fax_number": "330-373-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "address_2": "SUITE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437",
            "telephone_number": "330-372-2333",
            "fax_number": "330-373-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULA",
        "first_name": "JUSTIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.084818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2580434",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.