Individual provider Active NPI

Molly Hogan Mikuls, MPT

  • Physical Therapist
  • Norfolk, NE
National Provider Identifier
1699982199
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2005 Issued in NE
Practice address
2700 W Norfolk Ave
Norfolk, NE 68701-4438
Phone
(402) 644-7546
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2005 NE Primary

Addresses

Primary practice location

2700 W Norfolk Ave
Norfolk, NE 68701-4438

Mailing address

5602 Walnut St
Omaha, NE 68106-2263
Phone (402) 630-8114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160311002295 NE Practitioner - Physical Therapist in Private Practice 8022314301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

470 Maxwell PLZ
Omaha, NE 68154-2997
Phone (402) 278-6360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
Goodcare Athome Rehab, LLC Physical Therapist CurrentSince Jun 4, 2020 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

600 E Benjamin Ave
Norfolk, NE 68701
Phone (402) 370-3330

470 Maxwell Plz
Omaha, NE 68154
Phone (402) 235-4446

11909 Miracle Hills Dr
Omaha, NE 68154
Phone (402) 201-2216

1000 N West Ave
Ste 210
Sioux Falls, SD 57104
Phone (605) 403-0933

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699982199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 WALNUT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062263",
            "telephone_number": "402-630-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014438",
            "telephone_number": "402-644-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULS",
        "first_name": "MOLLY",
        "middle_name": "HOGAN",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.