Individual provider Active NPI

Paul T Mikulecky, MD

  • Internal Medicine Physician
  • Denver, CO
National Provider Identifier
1609862556
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35985 Issued in CO
Practice address
1531 Market St
Denver, CO 80202-1607
Phone
(303) 534-5536
Fax
(303) 788-6115
NPI assigned
Sep 26, 2005
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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 35985 CO Primary

Addresses

Primary practice location

1531 Market St
Denver, CO 80202-1607

Mailing address

1531 Market St
Denver, CO 80202-1607
Phone (303) 534-5536

Other identifiers 1

IdentifierTypeStateIssuer
01359850MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35985COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinidad Area Health Association Internal Medicine Past Accepting new patients
Inpatient Medicine Service PC Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1609862556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 MARKET ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021607",
            "telephone_number": "303-534-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 MARKET ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021607",
            "telephone_number": "303-534-5536",
            "fax_number": "303-788-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULECKY",
        "first_name": "PAUL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "35985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01359850",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.