NPIMap

Individual provider Active NPI

Christina Lee Mikesell, D.O.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
National Provider Identifier
1578756045
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
50432 Issued in MN
Practice address
2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone
(612) 813-3300
Fax
(612) 813-3349
NPI assigned
Aug 19, 2007
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 50432 MN
Pediatric Pulmonology Physician 2080P0214X 50432 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289

Mailing address

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone (612) 813-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20081010000268 MN Practitioner - Pulmonary DiseasePractitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 5890863369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Pediatric Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children's Respiratory and Critical Care Specialists PAGroup PAC ID 8022084235, 24 clinicians

Practice addresses (Care Compare)

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 291-2848

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4387
Phone (612) 813-3300

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 636-9443

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Respiratory & Critical Care Specialists. P.a. Pediatrics CurrentSince Nov 23, 2011 Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
NPI 1598824880 PastSince Nov 23, 2011 Accepting new patients

Locations

6060 Clearwater Dr
Ste 200
Hopkins, MN 55343
Phone (952) 930-8770

2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300

310 Smith Ave N
Ste 460
Saint Paul, MN 55102
Phone (651) 220-7000

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 4

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 8

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": "1187481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1578756045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESELL",
        "first_name": "CHRISTINA",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "50432",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MN",
            "license": "50432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.