Individual provider Active NPI

Timothy Edward Mikulas, APRN

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1801481361
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11011754 Issued in FL
Practice address
1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone
(904) 253-6910
Fax
(904) 253-6964
NPI assigned
Mar 6, 2021
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11011754 FL Primary

Addresses

Primary practice location

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535

Mailing address

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone (904) 253-6910

Other identifiers 1

IdentifierTypeStateIssuer
110669900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20210405000882 FL Practitioner - Nurse Practitioner 3173930476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1325 San Marco Blvd
Jacksonville, FL 32207-8568
Phone (904) 253-6910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.86 of 100Reported as group
Quality
85.7
Promoting interoperability
100
Improvement activities
40
Cost
78.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11011754FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Critical Care and Sleep Medicine Associates,Inc CurrentSince Mar 21, 2021 Accepting new patients

Locations

1325 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 253-6910

1325 San Marco Blvd
Ste 300
Jacksonville, FL 32207
Phone (904) 202-4243

1443 San Marco Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 253-6910

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1801481361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULAS",
        "first_name": "TIMOTHY",
        "middle_name": "EDWARD",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-06",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11011754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110669900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.