Mikel Angelo Alwis, M.D.
Individual provider Active NPI Family Medicine Physician · Barstow, CA
NPI 1790705671 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1790705671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A48518 (CA)
- Practice address
- 716 E Main St
Barstow, CA 92311-2354 - Phone
- (760) 256-6426
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050204000810 | CA | Practitioner - Family Practice | 8527019660 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48518 | CA | MD | General Practice Dentistry |
| A48518 | CA | MD | Family Medicine Physician |
Practice roles (10 of 11)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr.Mikel Walk in Clinic Inc | Family Medicine | Current | Accepting new patients |
| Dr Mikel Walk in Clinic | Current |
Accepting new patients | |
| Maithri N. Weerasinghe MD Inc | Family Medicine | Current |
Accepting new patients |
| Hospital of Barstow Inc | Past | Accepting new patients | |
| Corwin Medical Group Inc Ipa | Family Medicine | Past | Accepting new patients |
| St. Mary Medical Center | Past | Accepting new patients | |
| Victor Valley Community Hospital | Past | Accepting new patients | |
| Dr, Mikel Walk in Clinic | Past | Accepting new patients | |
| Inpatient Consultants of California, Inc. | Past | Accepting new patients | |
| Eisenhower Medical Center | Past | Accepting new patients |
Locations
12143 Navajo Rd
Apple Valley, CA 92308
Phone (760) 240-1144
716 E Main St
Barstow, CA 92311
Phone (760) 256-6426
15791 Bear Valley Rd
Hesperia, CA 92345
Phone (760) 678-3576
15626 Hesperia Rd
Victorville, CA 92395
Phone (760) 949-1231
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A48518 | CA | Yes |
Addresses
Primary practice location
716 E Main St
Barstow, CA 92311-2354
Mailing address
PO Box 487
Barstow, CA 92312-0487
Phone (760) 256-6426
Other names
- Maithri N. Weerasinghe
Other providers in Barstow, CA
- Michael David Allen
- Cindy Alexis Alva
- Aimee Alvarado
- Diana Vanessa Alvarado
- Aldo Felipe Alvarez
- Bryson Anderlik
- Lynda Diane Anderson
- Keisha Angelcor
- Angelic Touch Homecare 1Services Inc.
- Diana Ankir
All providers in Barstow, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.