Brandon C Mickelsen (NPI# 1417987686, PAC ID# 8022170620) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1417987686 |
| PAC ID by PECOS | 8022170620 |
| Professional Enrollment ID | I20081216000259 |
| Full Name | Brandon C Mickelsen |
| Organization Legal Name | FAMILY PRACTICE GROUP, P.A. |
| Address |
1951 Bench Rd B Pocatello ID 83201-2073 |
| Phone Number | 2082381000 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1658275391 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1951 Bench Rd B, Pocatello, ID 83201-2073 | 2082381000 | FAMILY PRACTICE GROUP, P.A. |
| 465 Memorial Dr, Pocatello, ID 83201-4008 | 20823278621122 | HEALTH WEST INC. |
| 777 Hospital Way, Pocatello, ID 83201-5175 | POCATELLO HEALTH SERVICES LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_039_overall | Screening for Osteoporosis for Women Aged 65-85 Years of Age | 79% | |
| MIPS_EC_039_overall | Screening for Osteoporosis for Women Aged 65-85 Years of Age | 79% | |
| MIPS_EC_048_overall | Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older | 51% | |
| MIPS_EC_048_overall | Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older | 51% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 79% | |
| MIPS_EC_110_overall | Preventive Care and Screening: Influenza Immunization | 79% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 56% | |
| MIPS_EC_111_overall | Pneumococcal Vaccination Status for Older Adults | 56% | |
| MIPS_EC_113_overall | Colorectal Cancer Screening | 41% | |
| MIPS_EC_113_overall | Colorectal Cancer Screening | 41% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 56% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 56% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_134_overall | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 69% | |
| MIPS_EC_134_overall | Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | 69% |
| Organization Legal Name | FAMILY PRACTICE GROUP, P.A. |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria E Ryan | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Michael A Anderson | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Zachary B Warnock | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Nicolette Hampton | Nurse Practitioner | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| David E Martin | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Scott Ryan Christensen | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Andrew W Thayne | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Megan L Tews | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Travis D Nielsen | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Stephanie Follett | Nurse Practitioner | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Street Address |
1951 BENCH RD B |
| City | POCATELLO |
| State | ID |
| Zip | 83201-2073 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria E Ryan | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Michael A Anderson | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Zachary B Warnock | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Nicolette Hampton | Nurse Practitioner | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| David E Martin | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Scott Ryan Christensen | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Andrew W Thayne | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Megan L Tews | Physician Assistant | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Travis D Nielsen | Family Medicine | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Stephanie Follett | Nurse Practitioner | Family Practice Group, P.a. | 1951 Bench Rd B, Pocatello, ID 83201-2073 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy A Flicker | Physical Therapy | 2839 Margo Ln, Pocatello, ID 83201-1961 | |
| Michael D Lance | Psychiatry | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Kenneth A Cogen | Nephrology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Randall J Skeem | Internal Medicine | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Martha Elizabeth Franz | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| John L Shuss | General Surgery | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Ciara C Christensen | Clinical Psychologist | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Robin L Hall | Nurse Practitioner | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Laurence L Martens | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Terry J Buccambuso | Diagnostic Radiology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Find all physicians in zip 83201 | |||
| City | POCATELLO |
| Zip Code | 83201 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | POCATELLO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Brandon C Mickelsen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.