Elizabeth Marie Mikulich, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4702611268 Issued in MI

Practice address

209 S State St
Ann Arbor, MI 48104-2005

Phone

(866) 389-2727

NPI assigned

Oct 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (3 of 7)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Jackson Orthopaedic Care & Surgery, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Jackson, MI
  • NPI 1609087626
  NPD (past)
• Jackson Orthopaedic Care & Surgery, P.C.

  • Orthopaedic Surgery Physician
  • Jackson, MI
  • NPI 1649341876
  NPD (past)

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1740533736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 TROON",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574768",
            "telephone_number": "269-420-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042005",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39350 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481679164",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKULICH",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4702611268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0872418",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Patricia Mikhail, M.D.
• Kaidi Mikhitarian, MD
• Zachary Miklja
• Daniel D Mikol, MD
• Amina Mikula, AUD
• Karen Clark Mikus, PH.D.
• John Robert Milanovich, PH.D.
• Stephen Milarch
• Allison Marie Milen, MD
• Chanelle Miles

• All providers in Ann Arbor, MI
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.