Active NPI
Ellen K. Mickels, M.D.
- Family Medicine Physician
- Kaneohe, HI
National Provider Identifier
1760566913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD-13156
- Practice address
- 46-056 Kamehameha Hwy
Suite 221
Kaneohe, HI 96744-3755 - Phone
- (808) 233-6200
- Fax
- (808) 233-6255
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD-13156 | HI | Primary |
Addresses
Primary practice location
46-056 Kamehameha Hwy
Suite 221
Kaneohe, HI 96744-3755
Mailing address
46-056 Kamehameha Hwy
Suite 221
Kaneohe, HI 96744-3755
Phone (808) 233-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000253914 | Other | HI | HMSA |
| 9158444 | Other | HI | UHA |
| 569618 01 | Medicaid | HI |
Other names 1
- Dr. Ellen K. Perzinski
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-13156 | HI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331856000000",
"number": "1760566913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46-056 KAMEHAMEHA HWY",
"address_2": "SUITE 221",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967443755",
"telephone_number": "808-233-6200",
"fax_number": "808-233-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46-056 KAMEHAMEHA HWY",
"address_2": "SUITE 221",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967443755",
"telephone_number": "808-233-6200",
"fax_number": "808-233-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKELS",
"first_name": "ELLEN",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2012-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "HI",
"license": "MD-13156",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "0000253914",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHA",
"identifier": "9158444",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "569618 01",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELLEN",
"last_name": "PERZINSKI",
"middle_name": "K.",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kaneohe, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.