Individual provider Active NPI

Joshua E Hulkonen, PA

  • Medical Physician Assistant
  • Menominee, MI
National Provider Identifier
1821545864
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601007994 Issued in MI
Practice address
1110 10TH Ave
Menominee, MI 49858-3058
Phone
(906) 290-5000
NPI assigned
Sep 7, 2016
Last updated
May 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601007994 MI Primary

Addresses

Primary practice location

1110 10TH Ave
Menominee, MI 49858-3058

Mailing address

894 Campus Dr
Ste B
Hancock, MI 49930-1644
Phone (906) 483-1445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161103002474 MI Practitioner - Physician Assistant 2062790553 Reassigns benefits to 1 organization
I20210713003358 WI Practitioner - Physician Assistant 2062790553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Dermatology Group LTDGroup PAC ID 9537312665, 23 clinicians

Practice addresses (Care Compare)

1606 S Stephenson Ave
Iron Mountain, MI 49801-3636
Phone (920) 965-0345

2601 1St Ave N
Escanaba, MI 49829-1448
Phone (920) 965-0345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007994MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Dermatology Group LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joshua.hulkonen.1@23194.direct.athenahealth.com

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

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1821545864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 CAMPUS DR",
            "address_2": "STE B",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301644",
            "telephone_number": "906-483-1445",
            "fax_number": "906-483-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 10TH AVE",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583058",
            "telephone_number": "906-290-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULKONEN",
        "first_name": "JOSHUA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601007994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menominee, MI

Sources for this page

Verify at the official NPI Registry.