John W Mielke (NPI# 1679508006, PAC ID# 0042104598) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GERIATRIC MEDICINE.
Nation Provider ID (NPI) | 1679508006 |
PAC ID by PECOS | 0042104598 |
Professional Enrollment ID | I20040214000080 |
Full Name | John W Mielke |
Organization Legal Name | OPTAGE PRIMARY CARE LLC |
Address |
2845 Hamline Ave N Roseville MN 55113-7127 |
Phone Number | 6516316100 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
Graduation Year | 1980 |
Primary Specialty | GERIATRIC MEDICINE |
Secondary Specialties | INTERNAL MEDICINE |
Group Practice PAC ID | 5092992172 |
Number of Group Practice Members | 18 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
240001 | NORTH MEMORIAL MEDICAL CENTER |
240063 | ST JOSEPH'S HOSPITAL |
240053 | PARK NICOLLET METHODIST HOSPITAL |
Address | Phone | Organization |
---|---|---|
2845 Hamline Ave N, Roseville, MN 55113-7127 | 6516316100 | OPTAGE PRIMARY CARE LLC |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
Organization Legal Name | OPTAGE PRIMARY CARE LLC |
Physicians | 14 |
Name | Specialty | Organization | Address |
---|---|---|---|
Judy L Palmer | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Amy Kammerer | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Mary Stephens | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Sherol L Holck | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Jennifer J Dart | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Jamie Tiede | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Kari M Garin | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Brandi Reilly | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Patricia C Henjum | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Lois R Sipprell | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Street Address |
2845 HAMLINE AVE N |
City | ROSEVILLE |
State | MN |
Zip | 55113-7127 |
Name | Specialty | Organization | Address |
---|---|---|---|
Judy L Palmer | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Amy Kammerer | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Mary Stephens | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Sherol L Holck | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Jennifer J Dart | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Jamie Tiede | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Kari M Garin | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Brandi Reilly | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Patricia C Henjum | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Lois R Sipprell | Nurse Practitioner | Optage Primary Care LLC | 2845 Hamline Ave N, Roseville, MN 55113-7127 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Stefano M Sinicropi | Orthopedic Surgery | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Matthew C Hawkins | Physician Assistant | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Eric S Salman | Physician Assistant | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Glenn R Buttermann | Orthopedic Surgery | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Daniel P Sipple | Physical Medicine and Rehabilitation | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Phillip Charles Stewart | Physician Assistant | Midwest Spine and Brain Institute LLC | 1835 W Country Rd C, Suite 150, Roseville, MN 55113 |
Grady J Glynn | Physical Therapy | Physicians Neck and Back Clinics | 3050 Centre Pointe Dr, Suite 200, Roseville, MN 55113-1179 |
Tonya M Wells | Physical Therapy | Physicians Neck and Back Clinics | 3050 Centre Pointe Dr, Suite 200, Roseville, MN 55113-1179 |
Caroline A Mason | Family Medicine | Physicians Neck and Back Clinics | 3050 Centre Pointe Dr, Suite 200, Roseville, MN 55113-1179 |
Rocklin A Shir | Emergency Medicine | Physicians Neck and Back Clinics | 3050 Centre Pointe Dr, Suite 200, Roseville, MN 55113-1179 |
Find all physicians in zip 55113 |
City | ROSEVILLE |
Zip Code | 55113 |
Specialty | GERIATRIC MEDICINE |
City + Specialty | ROSEVILLE + GERIATRIC MEDICINE |
Please comment or provide details below to improve the information on John W Mielke.
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.