DR. JUDITH K MICKELSON (M.D.) – Cardiovascular Disease Physician, NPI 1700876190
Cardiovascular Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. JUDITH K MICKELSON (M.D.)
60, High Street, Lewiston, Androscoggin County, Maine, 04240, United States
LEWISTON, ME 042407616
Phone: (207) 753-3900
Fax: (207) 753-3902
Type: Location
Select Specialty Hospital Cincinnati, 3219, Clifton Avenue, Clifton Heights–University Heights–Fairview, Cincinnati, Hamilton County, Ohio, 45220, United States
SUITE 400
CINCINNATI, OH 452203099
Phone: (513) 861-1260
Fax: (513) 872-8014
Type: Mailing
117 TRAIL CREEK CT
COTTLEVILLE, MO 633047594
Phone: (513) 543-0595
Type: Location
915 N Grand Blvd
Saint Louis, MO 631061621
Phone: (314) 652-4100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-10-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201125002545 | I | Cardiovascular Disease (Cardiology) | ME | TBD |
| I20211015002570 | I | Cardiovascular Disease (Cardiology) | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04240)
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Provider's Procedures
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