Carl Terence Mickman, MD - Medicare Emergency Medicine in New York, NY

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Carl Terence Mickman, MD is a medicare enrolled "Emergency Medicine" physician in New York, New York. He went to Louisiana State University School Of Medicine In New Orleans and graduated in 2014 and has 11 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice San Carlos Apache Healthcare Corporation, St. Bernard Emergency Group, Llc, Professional Emergency Medicine Management -- Lake Charles Llc, Belle Chasse Emergency Group Llc, St Tammany Emergency Physicians Group Llc and his current practice location is 1 Gustave L Levy Pl, Box 1149, New York, New York. You can reach out to his office (for appointments etc.) via phone at (612) 618-7945.

Carl Terence Mickman is licensed to practice in New York (license number 294040) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1124445242.

Contact Information

Carl Terence Mickman, MD
1 Gustave L Levy Pl, Box 1149,
New York, NY 10029-6504
(612) 618-7945
Not Available

Map and Direction




Physician's Profile

Full NameCarl Terence Mickman
GenderMale
SpecialityEmergency Medicine
Experience11 Years
Location1 Gustave L Levy Pl, New York, New York
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Carl Terence Mickman attended and graduated from Louisiana State University School Of Medicine In New Orleans in 2014
  NPI Data:
  • NPI Number: 1124445242
  • Provider Enumeration Date: 03/26/2014
  • Last Update Date: 06/24/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8729333133
  • Enrollment ID: I20201117001983

Medical Identifiers

Medical identifiers for Carl Terence Mickman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124445242NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 326621 (Louisiana)Secondary
390200000XStudent In An Organized Health Care Education/training Program (New York)Secondary
207P00000XEmergency Medicine 294040 (New York)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Lake Charles Memorial HospitalLake charles, LAHospital
Red Lake Hospital ARedlake, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
San Carlos Apache Healthcare Corporation0648580597111
St. Bernard Emergency Group, Llc478996097219
Professional Emergency Medicine Management -- Lake Charles Llc701213137811
Belle Chasse Emergency Group Llc711314007087
St Tammany Emergency Physicians Group Llc721425596744

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carl Terence Mickman allows following entities to bill medicare on his behalf.
Entity NamePhs Indian Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508809765
PECOS PAC ID: 4789598731
Enrollment ID: O20031114000287
Entity NamePine Ridge Indian Health Service Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497786412
PECOS PAC ID: 4688571326
Enrollment ID: O20031218000966
Entity NameRosebud Indian Health Service
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194757369
PECOS PAC ID: 6901704055
Enrollment ID: O20031226000337
Entity NameEagle Butte Indian Health Service Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558395848
PECOS PAC ID: 7517852759
Enrollment ID: O20040217001024
Entity NameFort Yates Indian Health Service Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609851039
PECOS PAC ID: 3678462744
Enrollment ID: O20040315001479
Entity NameSan Carlos Apache Healthcare Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265813075
PECOS PAC ID: 0648580597
Enrollment ID: O20151105002091

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carl Terence Mickman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Carl Terence Mickman, MD
1 Gustave L Levy Pl, Box 1149,
New York, NY 10029-6504

Ph: (612) 618-7945		Carl Terence Mickman, MD
1 Gustave L Levy Pl, Box 1149,
New York, NY 10029-6504

Ph: (612) 618-7945

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.