NPIMap

Individual provider Active NPI

Timothy Alan Mikesell, M.D.

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1669811220
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125.062755 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62702-3757
Phone
(217) 757-2387
Fax
(217) 788-5582
NPI assigned
Jun 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125.062755 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62702-3757

Mailing address

701 N 1St St
Box 101
Springfield, IL 62781-0001
Phone (217) 757-2387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230317000851 NE Practitioner - Diagnostic Radiology 7911140900 Reassigns benefits to 2 organizations
I20230330002932 SD Practitioner - Diagnostic Radiology 7911140900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Southern Illinois University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, shared by 17 NPIs, 151 clinicians

Practice addresses (Care Compare)

1000 W 4TH St
Suite 8
Yankton, SD 57078-3700

300 N 2ND St
O'Neill, NE 68763-1514
Phone (402) 336-2611

405 W Darlene St
Avera Behavioral Health Yankton
Hartington, NE 68739-0937
Phone (402) 254-3935

501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.062755ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services CurrentSince Mar 1, 2023 Accepting new patients
Avera St Anthonys Hospital Current Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services CurrentSince Mar 1, 2023 Accepting new patients
Sacred Heart Health Services Diagnostic Radiology CurrentSince Mar 1, 2023 Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients

Locations

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

501 Summit St
Ste 8
Yankton, SD 57078
Phone (605) 668-8000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1669811220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "address_2": "BOX 101",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-757-2387",
            "fax_number": "217-788-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-757-2387",
            "fax_number": "217-788-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKESELL",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125.062755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.