Irene R Mirkin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29156 Issued in WI

Practice address

7780 Elmwood Ave
Middleton, WI 53562-5407

Phone

(608) 417-3434

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1912949256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507",
            "telephone_number": "608-417-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7780 ELMWOOD AVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625407",
            "telephone_number": "608-417-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRKIN",
        "first_name": "IRENE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "29156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31391800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIC PROVIDER #",
            "identifier": "1000324",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Clare Miller, MD
• Casey Lauren Mills, PHARMD
• David Mincberg, ATC, NREMT
• Adam S Miner, PSY.D.
• Michelle Lynn Minter
• Theresa Marcie Mock, DENTAL HYGIENIST
• Marcia Marie Moe
• Amy Mofle
• Salim Sheik Mohamud
• Sanbrita Mondal, O.D.

• Internal Medicine Physician in Middleton, WI
• Providers in Middleton, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.