Individual provider Active NPI

Scott A Mihalik, P.A.-C.

  • Physician Assistant
  • Saint Joseph, MI
National Provider Identifier
1518128073
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005294 Issued in MI
Practice address
3950 Hollywood Rd Ste 110
Saint Joseph, MI 49085-9151
Phone
(269) 985-1000
Fax
(269) 983-3181
NPI assigned
Jun 18, 2008
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005294 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 110
Saint Joseph, MI 49085-9151

Mailing address

PO Box 11091
South Bend, IN 46634-0091

Other identifiers 1

IdentifierTypeStateIssuer
5601005294OtherMISTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20080816000020 MI Practitioner - Physician Assistant 2961577572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1234 Napier Ave
Corewell Health Lakeland Hospitals
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

3950 Hollywood Rd
Saint Joseph, MI 49085-9151
Phone (269) 985-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Assoc of Southwestern Michigan, PC Current Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Apr 24, 2019 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince May 1, 2025 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Apr 24, 2019 Accepting new patients
Community Hospital Past Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Locations

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 110
Saint Joseph, MI 49085
Phone (269) 985-1000

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: smihalik1270876@epic00.corewelldirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1518128073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11091",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466340091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 110",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859151",
            "telephone_number": "269-985-1000",
            "fax_number": "269-983-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHALIK",
        "first_name": "SCOTT",
        "middle_name": "A",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5601005294",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.