Individual provider Active NPI

Michael Kevin Engelken, MD

  • Family Medicine Physician
  • Holton, KS
National Provider Identifier
1972602514
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-24501 Issued in KS
Practice address
1110 Columbine Drive
Holton, KS 66436
Phone
(785) 364-2116
Fax
(785) 364-9613
NPI assigned
Sep 21, 2006
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-24501 KS Primary

Addresses

Primary practice location

1110 Columbine Drive
Holton, KS 66436

Mailing address

1110 Columbine Drive
Holton, KS 66436
Phone (785) 364-2116

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040324000048 KS Practitioner - Family Practice 3577464809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Resources of Jackson Co IncGroup PAC ID 7810807690, shared by 8 NPIs, 27 clinicians

Practice addresses (Care Compare)

1110 Columbine Dr
Holton, KS 66436-8824
Phone (785) 364-2126

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-24501KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Resources of Jackson Co Inc CurrentSince Apr 1, 2020 Accepting new patients
Rural Health Resources of Jackson Co Inc Current Accepting new patients
Rural Health Resources of Jackson Co Inc Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Rural Health Resources of Jackson Co Inc Current Accepting new patients
Prairie Family Medicine Associates, P.a. Family Medicine Past Accepting new patients

Locations

1100 Columbine Dr
Holton, KS 66436
Phone (785) 364-2114

1110 Columbine Dr
Holton, KS 66436
Phone (785) 364-2126

Interoperability endpoints

  • Direct secure messaging: michael.engelken.1@16424.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1972602514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COLUMBINE DRIVE",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "66436",
            "telephone_number": "785-364-2116",
            "fax_number": "785-364-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 COLUMBINE DRIVE",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "66436",
            "telephone_number": "785-364-2116",
            "fax_number": "785-364-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELKEN",
        "first_name": "MICHAEL",
        "middle_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-24501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holton, KS

Sources for this page

Verify at the official NPI Registry.