Eleni Marie Mijalis

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

T-4423 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 815-3037

NPI assigned

Apr 4, 2021

Last updated

Sep 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Otolaryngology

Education

Louisiana State University School of Medicine in Shreveport, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1699354019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LAKELAND DR APT 364",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164627",
            "telephone_number": "318-286-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJALIS",
        "first_name": "ELENI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-04",
        "last_updated": "2021-09-09",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "T-4423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey C Middleton, SLP
• Robert Middleton, MD
• Steve Middleton
• Romero Keith Midgett, M.D.
• Elisa Miguel-Qin, MD
• Shannon Ayiesha Milbourne, M.D.
• Richard John Miles, DO
• Milestone Pediatric Medical Center
• Milestone Primary Care House Calls, LLC
• Matthew Paul Miley, DO

• Otolaryngology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Otolaryngology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.