NPIMap

Individual provider Active NPI

Michael A Mistretta, M.D.

  • Pulmonary Disease Physician
  • Richmond, VA
National Provider Identifier
1003832817
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101052617 Issued in VA
Practice address
6600 W Broad St Ste 300
Richmond, VA 23230-1709
Phone
(804) 320-4243
Fax
(804) 622-0552
NPI assigned
Jul 14, 2006
Last updated
May 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101052617 VA
Pulmonary Disease Physician 207RP1001X 0101052617 VA Primary

Addresses

Primary practice location

6600 W Broad St Ste 300
Richmond, VA 23230-1709

Mailing address

1000 Boulders Pkwy
Suite 102
Richmond, VA 23225-5545
Phone (804) 320-4243

Other identifiers 8

IdentifierTypeStateIssuer
4800040OtherVAUNITED HEALTHCARE PROV #
223643OtherVAANTHEM
80057OtherVASOUTHER HEALTH PROVIDER #
005812682MedicaidVA
557515OtherVAAETNA
021790OtherVACIGNA PROVIDER NUMBER
12178OtherVACARENET PROVIDER NUMBER
7044153OtherVAMAMSI PROVIDER NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michaelmistretta@par.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070220000850 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9931201068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Associates of Richmond IncGroup PAC ID 8123095577, 49 clinicians

Practice addresses (Care Compare)

1603 Santa Rosa Rd
RM 101
Richmond, VA 23229-5010
Phone (804) 288-2711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.54 of 100Reported as group
Quality
71.96
Promoting interoperability
99
Improvement activities
40
Cost
77.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101052617VAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates of Richmond Inc CurrentSince Dec 1, 2006 Accepting new patients
Dysphagia Management Systems, LLC PastSince Jan 19, 2023 Accepting new patients

Locations

2354 Colony Crossing Pl
Midlothian, VA 23112
Phone (804) 288-6261

1000 Boulders Pkwy
Ste 102
North Chesterfield, VA 23225
Phone (804) 591-3134

2025 Waterside Rd
Prince George, VA 23875

1603 Santa Rosa Rd
Rm 101
Richmond, VA 23229
Phone (804) 288-2711

6600 W Broad St
Ste 300
Richmond, VA 23230
Phone (804) 591-3134

7650 E Parham Rd
Ste 300
Richmond, VA 23294
Phone (804) 762-9880

Networks

  • KY PPO
  • TN PPO C-SNP
  • KY PPO C-SNP
  • TN PPO
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: michaelmistretta@par.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1003832817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOULDERS PKWY",
            "address_2": "SUITE 102",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232255545",
            "telephone_number": "804-320-4243",
            "fax_number": "804-282-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W BROAD ST STE 300",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301709",
            "telephone_number": "804-320-4243",
            "fax_number": "804-622-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101052617",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101052617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV #",
            "identifier": "4800040",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "223643",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHER HEALTH PROVIDER #",
            "identifier": "80057",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005812682",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "557515",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "021790",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENET PROVIDER NUMBER",
            "identifier": "12178",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER NUMBER",
            "identifier": "7044153",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michaelmistretta@par.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "6600 W Broad St Ste 300",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232301709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.