Kelsi Mici, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.008648RX Issued in OH

Practice address

2940 N McCord Rd
Toledo, OH 43615-1753

Phone

(419) 842-3000

Fax

(419) 842-3047

NPI assigned

Dec 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

University of Toledo College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Northwest Ohio Cardiology Consultants LLCGroup PAC ID 4981752938, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Memorial Hospital Hospital, Fremont, OH, CCN 360156
• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
• Wood County Hospital Hospital, Bowling Green, OH, CCN 360029
• Fostoria Community Hospital Hospital, Fostoria, OH, CCN 361318

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmici309723@direct.promedica.org

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.

• Promedica Northwest Ohio Cardiology Consultants, LLC

  • Cardiovascular Disease Physician
  • Toledo, OH
  • NPI 1780820555

  MI

  Medicare reassignment Care Compare group
• Promedica Northwest Ohio Cardiology Consultants, LLC

  • Cardiac Rehabilitation Registered Nurse
  • Toledo, OH
  • NPI 1649559394
  NPD

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

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation
• Fostoria Hospital Association

  • Critical Access Hospital
  • Fostoria, OH
  • NPI 1275533226
  Care Compare affiliation
• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation
• Wood County Hospital Assn

  • General Acute Care Hospital
  • Bowling Green, OH
  • NPI 1790751253
  Care Compare affiliation

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1982317566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-842-3047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5640 N Adrian Hwy # A",
            "address_purpose": "LOCATION",
            "city": "Adrian",
            "state": "MI",
            "postal_code": "492218318",
            "country_code": "US",
            "telephone_number": "517-577-0525",
            "fax_number": "517-266-0956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICI",
        "first_name": "KELSI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-28",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008648RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon Michel
• Michelle Adult Home Care Provider LLC
• Michelle Coutcher and Associates LLC
• Michelle Lacy Bowman
• Michelle Roundtree
• Hannah Harms Mickael, LISW-S
• Mid-US Medical Inc.
• Chantel Midcalf
• Keishon Midcalf
• Tabatha Midcalf

• Physician Assistant in Toledo, OH
• Providers in Toledo, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.