Mariano B Mikulic, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME73598 Issued in FL

Practice address

1824 King Street
Suite 300
Jacksonville, FL 32204-4736

Phone

(904) 388-1820

Fax

(904) 388-1827

NPI assigned

May 23, 2005

Last updated

May 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040
• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent's Clay County Hospital, Middleburg, FL, CCN 100321
• Memorial Satilla Health Hospital, Waycross, GA, CCN 110003
• Bacon County Hospital Hospital, Alma, GA, CCN 111327

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mariano.mikulic.1@8967.direct.athenahealth.com

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  Cardiovascular Disease, GA

  Medicare reassignment Care Compare group NPD
• Cardiology Interpreters Inc

  • Cardiology Technician
  • Jacksonville, FL
  • NPI 1477887149
  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Southern Heart Group

  dba Diagnostic Cardiology Assoc

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1962484220
  NPD (past)

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

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center-Clay County, Inc.

  dba Ascension St. Vincent's Clay County

  • General Acute Care Hospital
  • Middleburg, FL
  • NPI 1457690471
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation
• Bacon County Health Services, Inc.

  • Critical Access Hospital
  • Alma, GA
  • NPI 1629185285
  Care Compare affiliation
• Southeast Georgia Health Services, L.L.C.

  dba Memorial Satilla Health

  • Rural Acute Care Hospital
  • Waycross, GA
  • NPI 1922530468
  Care Compare affiliation

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1639172836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING STREET",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING STREET",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULIC",
        "first_name": "MARIANO",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME73598",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "046312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "365273",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "245320",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00793581D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42895",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254507100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2049932",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00793581A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miksell Physical Therapy & Wellness
• Taylor Miksell, DPT
• Christopher James Mikulas
• Natalie Mikulas, DNP
• Timothy Edward Mikulas, APRN
• Sara Milan, PT, DPT, OCS
• Anthony Milani
• Guillermo Cabugao Milano Jr., ATC,LAT
• Sarah Lauren Milano, BSN, RN, LAT, ATC
• Roell T Milbry Jr.

• Cardiovascular Disease Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.