Individual provider Active NPI

Aaron Mickelson, D.O.

  • Emergency Medicine Physician
  • Miami Beach, FL
National Provider Identifier
1861730541
Registry record updated Feb 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS12518 Issued in FL
Practice address
4300 Alton Rd
Miami Beach, FL 33140-2948
Phone
(305) 535-7953
NPI assigned
Jan 30, 2013
Last updated
Feb 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS12518 FL Primary
Emergency Medicine Physician 207P00000X 6572 AZ

Addresses

Primary practice location

4300 Alton Rd
Miami Beach, FL 33140-2948

Mailing address

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 535-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150919000006 AZ Practitioner - Emergency Medicine 0143448035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians

Practice addresses (Care Compare)

4328 E Chandler Blvd
Phoenix, AZ 85048-8839
Phone (888) 732-3317

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chandler Emergency Medical Group, LLC Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Aug 13, 2020 Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

4328 E Chandler Blvd
Phoenix, AZ 85048
Phone (480) 454-3630

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dignity Health Arizona General HospitalLaveen, AZ, CCN 030136 Hospital Corporate Officer
W-2 Managing Employee
May 1, 2022
May 1, 2022

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 9

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": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423958400000",
    "number": "1861730541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-535-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-535-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2015-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS12518",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "6572",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.