NPIMap

Individual provider Active NPI

Rakesh Mittal, MD, PHD

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1023046562
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0073653 Issued in FL
Practice address
5880 49TH St N
Suite N105
St Petersburg, FL 33709-2150
Phone
(727) 527-0797
Fax
(727) 528-7703
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0073653 FL Primary

Addresses

Primary practice location

5880 49TH St N
Suite N105
St Petersburg, FL 33709-2150

Mailing address

5880 49TH St N
Suite N105
St Petersburg, FL 33709-2150
Phone (727) 527-0797

Other identifiers 1

IdentifierTypeStateIssuer
253504100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050111000201 FL Practitioner - Internal Medicine 9335197938 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5880 49TH St N
Suite 202N
St Petersburg, FL 33709-2147
Phone (727) 527-0797

5880 49TH St N
Suite N202
St Petersburg, FL 33709-2150
Phone (727) 527-0797

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0073653FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinellas Internal Medicine Specialists, PA CurrentSince Aug 24, 2011 Accepting new patients
Pinellas Medical Specialists Internal Medicine CurrentSince Jun 18, 2020 Accepting new patients
Sunstate Physicians LLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Community Hospitalists of Pinella PastSince Feb 2, 2006 Accepting new patients
Elias Kanaan MD PA Internal Medicine PastSince Aug 20, 2001 Accepting new patients

Locations

2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469

801 West Bay Dr
Ste 321
Largo, FL 33770
Phone (561) 302-6086

5880 49th St N
Ste N105
St Petersburg, FL 33709
Phone (727) 291-1660

5880 49th St N
Ste N202
St Petersburg, FL 33709
Phone (727) 527-0797

5880 49th St N
Ste 202N
St Petersburg, FL 33709
Phone (727) 527-0797

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDJAA

Organizations & group practices 5

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1023046562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N",
            "address_2": "SUITE N105",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-527-0797",
            "fax_number": "727-528-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N",
            "address_2": "SUITE N105",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-527-0797",
            "fax_number": "727-528-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "RAKESH",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0073653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253504100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.