Individual Healthcare Provider
Mikaela Ann Altis, PA-C
Provider's NPPES record last updated: October 18, 2024
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1366053241
- Primary Specialty
- Physician Assistant — Medical
- Practice Location
- Fort Leavenworth, Kansas
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 8:05 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Medical
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363AM0700X Student in an Organized Health Care Education/Training Program
Student, Health Care
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.
Taxonomy code 390200000X
Practice Locations
Practice Location
550 Pope Ave
Fort Leavenworth, Kansas 66027-2332
Phone: (913) 684-6258
Additional Practice Location
315 W Gary Blvd
Clinton, Oklahoma 73601-2835
Phone: (580) 547-0900
Additional Practice Location
3600 N Garfield St
Midland, Texas 79705-6329
Phone: (806) 743-3220
Record Information
- Enumeration Date
- August 13, 2020
- Provider's NPPES Record Last Updated
- October 18, 2024
- Certification Date
- October 18, 2024
- NPISignal NPPES Dataset
- August 2026
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