Individual provider Active NPI

Stephen E Mikos, M.D.

  • Internal Medicine Physician
  • Roswell, GA
National Provider Identifier
1770566523
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
034201 Issued in GA
Practice address
1265 Upper Hembree Rd
Suite 200
Roswell, GA 30076-1143
Phone
(770) 442-1180
Fax
(770) 442-5824
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 034201 GA Primary

Addresses

Primary practice location

1265 Upper Hembree Rd
Suite 200
Roswell, GA 30076-1143

Mailing address

1265 Upper Hembree Rd
Suite 200
Roswell, GA 30076-1143
Phone (770) 442-1180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111012000497 GA Practitioner - Internal Medicine 5597937797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
90
Improvement activities
40
Cost
71.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034201GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Value in Prevention of Georgia Roswell LLC Internal Medicine CurrentSince Feb 1, 2024 Accepting new patients
Perimeter North Internal Medicine, PC Internal Medicine CurrentSince Jul 1, 1966 Accepting new patients

Locations

4950 Communication Ave
Ste 100
Boca Raton, FL 33431
Phone (561) 982-4300

1265 Upper Hembree Rd
Ste 200
Roswell, GA 30076
Phone (770) 442-1180

Organizations & group practices 2

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": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1770566523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "SUITE 200",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-442-1180",
            "fax_number": "770-442-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "SUITE 200",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-442-1180",
            "fax_number": "770-442-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOS",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.