David J Mickus, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20825 Issued in AZ

Practice address

4515 S McClintock Dr
Ste 100
Tempe, AZ 85282-7381

Phone

(480) 820-1133

Fax

(480) 820-9292

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

University of Minnesota Medical School, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

East Valley Primary Care Physicians PLCGroup PAC ID 2860471893, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Merit-based Incentive Payment System (MIPS)

Final score

27.42 of 100Reported as individual

Quality

15

Improvement activities

0

Cost

71.4

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Valley Primary Care Physicians PLC

  • Adult Medicine Physician
  • Tempe, AZ
  • NPI 1538177449
  Medicare reassignment Care Compare group NPD

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

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1871599688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR",
            "address_2": "STE 100",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-820-1133",
            "fax_number": "480-820-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR",
            "address_2": "STE 100",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827381",
            "telephone_number": "480-820-1133",
            "fax_number": "480-820-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKUS",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "20825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad L Michael, RPH
• Joel Michael Michaels, O.D.
• Rachelle E Michaels, APDH
• Lucinda Rae Michel, D.O.
• Guy Merrick Mickens, MS, BCBA, LBA
• Monifa Middleton
• Anneka Miguel
• Debra Kay Mikkelsen, MS CCC SLP
• Vince Toivo Mikkola, LPC
• Robert Carl Milam, MD

• Internal Medicine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.