{"npi":"1801300330","type":"NPI-1","status":"active","name":{"display":"Alejandro Mikelonis PA-C","other":[{"code":"5","type":"Also known as","value":"MIKELONIS, ALEX"}],"first":"ALEJANDRO","last":"MIKELONIS","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"IN","license":"10002386A"}]},"addresses":[{"purpose":"LOCATION","street_1":"610 N MICHIGAN ST STE 306","city":"SOUTH BEND","state":"IN","postal_code":"466011079","country_code":"US","phone":"5746476500","fax":"5746476518"},{"purpose":"MAILING","street_1":"710 N NILES AVE","city":"SOUTH BEND","state":"IN","postal_code":"466171924","country_code":"US","phone":"5746471610","fax":"5742376069"}],"license":{"state":"IN","number":"10002386A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"300008855","state":"IN","issuer":null},{"type_code":"01","label":"Other","value":"236040257","state":"IN","issuer":"MEDICARE PTAN"},{"type_code":"01","label":"Other","value":"M59677010","state":"IN","issuer":"MEDICARE PTAN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20171214000073","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"IN","pac_id":"4688932965"}]},"enumeration_date":"2017-11-20","last_updated":"2017-12-21","_meta":{"source":"NPPES","snapshot_date":"2017-12-21","doc_url":"https://findmynpi.com/api"}}