Individual provider Active NPI

Edward Mikula, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1639506165
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C05207 Issued in MD
Practice address
301 St. Paul Place
Heart Center at Mercy
Baltimore, MD 21202
Phone
(410) 332-9752
NPI assigned
Sep 30, 2013
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C05207 MD Primary

Addresses

Primary practice location

301 St. Paul Place
Heart Center at Mercy
Baltimore, MD 21202

Mailing address

301 St. Paul Place
Medical Staff Office
Baltimore, MD 21202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20131127000250 MD Practitioner - Physician Assistant 3779719547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

301 Saint Paul St
Baltimore, MD 21202-2102

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists, Inc. CurrentSince Oct 7, 2013 Accepting new patients
St Paul Place Specialists Inc CurrentSince Oct 7, 2013 Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients

Locations

11121 York Rd
Hunt Valley, MD 21030
Phone (410) 628-0026

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

114 Business Center Dr
Reisterstown, MD 21136
Phone (410) 661-3338

Interoperability endpoints

  • Direct secure messaging: emikula32432@direct.mdmercy.com

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 1

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1639506165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "HEART CENTER AT MERCY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-332-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULA",
        "first_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C05207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.