Lorin Mickelsen IV, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07001281A Issued in IN

Practice address

4233 Gateway Blvd
Newburgh, IN 47630

Phone

(812) 858-5786

Fax

(812) 490-4512

NPI assigned

Jul 13, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Clinic IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmickelsen201867@direct.deaconess.com

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585

  Multi-Specialty

  Medicare reassignment NPD
• Deaconess Clinic, Inc

  • Family Medicine Physician
  • Morganfield, KY
  • NPI 1891941688

  Multi-Specialty

  Medicare reassignment NPD
• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310

  Multi-Specialty

  NPD
• Deaconess Clinic Inc.

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1033365986

  Multi-Specialty

  NPD
• Deaconess Clinic, Inc

  • Family Medicine Physician
  • Henderson, KY
  • NPI 1306092192

  Multi-Specialty

  NPD
• Deaconess Clinic, Inc

  • Rural Health Clinic/Center
  • Petersburg, IN
  • NPI 1831345792

  Multi-Specialty

  NPD (past)

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

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1689058356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-858-5786",
            "fax_number": "812-490-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "47630",
            "telephone_number": "812-858-5786",
            "fax_number": "812-490-4512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Merritt Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424202788",
            "country_code": "US",
            "telephone_number": "270-827-0064",
            "fax_number": "270-826-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICKELSEN",
        "first_name": "LORIN",
        "name_suffix": "IV",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "243967",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "00433",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001281A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Messic, P.T.
• Cindy Messier
• Katie Marie Meth
• Cameron Michael Metzger, MD
• Gary Ray Meyer, D.D.S.
• Caleb Mikeworth
• Tracy L Miles, BSN,RN,CMSRN
• Brandi Millay
• Miller and Cook Pediatric Dentistry
• Miller Anesthesia & Pain LLC

• Podiatrist in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.