NPIMap

Individual provider Active NPI

Betsy Rose Mikac, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Orchard Park, NY
National Provider Identifier
1871124560
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345383-01 Issued in NY
Practice address
3671 Southwestern Blvd Ste 101
Orchard Park, NY 14127-1749
Phone
(716) 662-7008
Fax
(716) 662-5226
NPI assigned
Jan 31, 2020
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345383-01 NY Primary

Addresses

Primary practice location

3671 Southwestern Blvd Ste 101
Orchard Park, NY 14127-1749

Mailing address

3671 Southwestern Blvd Ste 101
Orchard Park, NY 14127-1749
Phone (716) 662-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200724001539 NY Practitioner - Nurse Practitioner 8628492519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Robert Erickson DO and Jennifer Erickson DO LLCGroup PAC ID 5991748626, 13 clinicians

Practice addresses (Care Compare)

3671 Southwestern Blvd
Suite 101
Orchard Park, NY 14127-1749
Phone (716) 662-7008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F345383-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Erickson DO and Jennifer Erickson DO LLC CurrentSince Jun 1, 2020 Accepting new patients
Robert Erickson DO and Jennifer Erickson DO LLC CurrentSince Jun 1, 2020 Accepting new patients

Locations

3671 Southwestern Blvd
Ste 101
Orchard Park, NY 14127
Phone (716) 662-7008

Interoperability endpoints

  • Direct secure messaging: bmikac@familypractice.medentdirect.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.

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1871124560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD STE 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 SOUTHWESTERN BLVD STE 101",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271749",
            "telephone_number": "716-662-7008",
            "fax_number": "716-662-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKAC",
        "first_name": "BETSY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345383-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.