Sean Mickelsen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60053 Issued in CA

Practice address

3851 Katella Ave Ste 255
Los Alamitos, CA 90720-3353

Phone

(562) 732-4578

NPI assigned

Sep 14, 2021

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 HI

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

Specialty

Physician Assistant

Education

Jefferson Medical College of Thomas Jefferson University, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smickelsen766105@direct.memorialcare.org

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group
• The Queen's Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1487693586
  Medicare reassignment
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  NPD
• The Queens Medical Center

  dba Queen's Island Urgent Care

  • Urgent Care Clinic/Center
  • Honolulu, HI
  • NPI 1235773219
  NPD
• The Queens Medical Center - Progressive Care Unit

  • Skilled Nursing Facility
  • Honolulu, HI
  • NPI 1851389365
  NPD (past)

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

• Queens North Hawaii Community Hospital

  • General Acute Care Hospital
  • Kamuela, HI
  • NPI 1477559029
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1538839246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE STE 255",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203353",
            "telephone_number": "562-732-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE STE 255",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203353",
            "telephone_number": "562-732-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSEN",
        "first_name": "SEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2022-12-20",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael K. Kim, M.D.
• Michael K. Kim, M.D., a Professional Corporation
• Michael W. Lauermann, M.D. a Professional Medical Corporation
• Rachel Michell, SLPA
• Michelle H. Reddy M.D., Inc.
• Keith Eugene Miller, CATC
• Laura Elizabeth Miller, DDS
• Scott James Miller, DDS
• Todd Covington Miller, M.D.
• Sasa Milosevic

• Physician Assistant in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.