NPIMap

Organization Active NPI

Dr, Mikel Walk in Clinic

  • General Practice Physician
  • Victorville, CA
National Provider Identifier
1942428263
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A48518 Issued in CA
Legal business name
DR, MIKEL WALK IN CLINIC
Practice address
15626 Hesperia Rd
Victorville, CA 92392
Phone
(760) 949-1231
Fax
(760) 949-1236
NPI assigned
Apr 23, 2007
Last updated
Nov 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Mikel A Alwis, MDNPI 1790705671
Title
President
Phone
(760) 221-9298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X A48518 CA Primary

Addresses

Primary practice location

15626 Hesperia Rd
Victorville, CA 92392

Mailing address

15791 Bear Valley Rd
Hesperia, CA 92345-1746
Phone (760) 949-1231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000996 CA Part B Supplier - Clinic/Group Practice 1557314572 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hesperia, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1068500Dr Mikel Walk-in Clinic15626 Hesperia Rd, Victorville, CA 92392Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Drmikel Walk in Clinic Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1942428263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15791 BEAR VALLEY RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451746",
            "telephone_number": "760-949-1231",
            "fax_number": "760-949-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15626 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "760-949-1231",
            "fax_number": "760-949-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR, MIKEL WALK IN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "ALWIS",
        "authorized_official_first_name": "MIKEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-221-9298",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A48518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.