Nanette M Mickiewicz, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

G646700 Issued in CA

Practice address

1555 Soquel Dr
Santa Cruz, CA 95065-1705

Phone

(831) 462-7512

Fax

(415) 591-2446

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1558319079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 FREDERICK ST",
            "address_2": "STE 203",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622239",
            "telephone_number": "831-462-7512",
            "fax_number": "415-591-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7512",
            "fax_number": "415-591-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKIEWICZ",
        "first_name": "NANETTE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G646700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G646700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonia Miano
• Michael Scott, Licensed Marriage and Family Therapist, Inc.
• Gail Fay Michaelis-Ow, NP
• Joyce Alice Michaelson, M.S.W, LCSW
• Pierre Sebastien Michel
• Midline LLC
• Elizabeth Anne Mier, RN
• Laurie Migliore, M.A.
• Milan C. Patel, M.D., Inc.
• Catherine Milazzo, IBCLC

• Infectious Disease Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.