Alejandro Mikelonis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002386A Issued in IN

Practice address

610 N Michigan St Ste 306
South Bend, IN 46601-1079

Phone

(574) 647-6500

Fax

(574) 647-6518

NPI assigned

Nov 20, 2017

Last updated

Dec 21, 2017By the provider in NPPES

Sex

Male

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 3

Other names 1

• Alex Mikelonis Other name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alejandromikelonis@beacon.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  dba Med Point Urgent Care Center at CR 6

  • Family Medicine Physician
  • Elkhart, IN
  • NPI 1710329008
  NPD
• Beacon Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1831149525
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Hospital of Bremen, Inc

  • Critical Access Hospital
  • Bremen, IN
  • NPI 1568417004
  Care Compare affiliation
• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Memorial Epworth Center

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  dba Beacon Granger Hospital, A Memorial Hospital Extension

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1801300330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N MICHIGAN ST STE 306",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011079",
            "telephone_number": "574-647-6500",
            "fax_number": "574-647-6518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011033",
            "country_code": "US",
            "telephone_number": "574-647-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKELONIS",
        "first_name": "ALEJANDRO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002386A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M59677010",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "236040257",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300008855",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "MIKELONIS",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.
• 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.