ELLEN MIKRUT MD
NPI 1710735915
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Q: What is Ellen Mikrut's NPI number?

The NPI number for Ellen Mikrut is 1710735915. It was assigned to this individual provider in the NPPES registry on May 11, 2024.

Q: What is Ellen Mikrut's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ellen Mikrut was last updated on May 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 11, 2024PECOS Enrolled

1441 N 12TH ST, PHOENIX, AZ 85006(602) 521-5700(602) 521-5701 Get Directions Write a Review

NPPES record last updated: May 11, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ellen Mikrut Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLEN MIKRUT MD (NPI 1710735915) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710735915

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameELLEN MIKRUTCredential: MD

Location Address1441 N 12TH STPhoenix, AZ 85006-2837

Mailing Address1111 E Mcdowell RdPhoenix, AZ 85006-2612 · (602) 839-3827 · Fax (602) 839-2359

Phone(602) 521-5700

Fax(602) 521-5701

Sole ProprietorNo

Enumeration DateMay 11, 2024

NPPES CertifiedMay 11, 2024

✔ NPI 1710735915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1441 N 12TH ST, Phoenix, AZ 85006

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen Mikrut Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSEY RENTERIA NP

Nurse Practitioner