Amy Mikulec

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

017304 Issued in OH

Practice address

12930 Chippewa Rd
Brecksville, OH 44141-2100

Phone

(216) 409-1953

NPI assigned

May 25, 2018

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1871084814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BANNER PHYSICAL THERAPY AND REHAB BOSWELL",
            "address_2": "10503 W THUNDERBIRD BLVD SUITE 263A",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "85351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12930 CHIPPEWA RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412100",
            "telephone_number": "216-409-1953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Banner Physical Therapy and Rehab Boswell",
            "address_2": "10503 W Thunderbird Blvd Suite 263A",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "85351",
            "country_code": "US",
            "telephone_number": "623-888-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKULEC",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13677",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "017304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "13677",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO PHYSICAL THERAPY LICENSE",
            "identifier": "017304",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Melichar, OTR/L
• Memory & Psychological Services, Inc.
• Anthony Menendez, PHD BCBA-D
• Rose Marie Mercer, LPC LICDC
• Blondelle Andrea Midamba, MS, RD, LD
• Greg Milanich, PHARMD, FASCP
• Cari McNelis Miller, OTR/L
• Dominic Ross Miller
• Haewon Suzanna Miller
• Jaclyn Miller, PH.D.

• Physical Therapist in Brecksville, OH
• Providers in Brecksville, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.