Individual provider Active NPI

Neeti Mittal, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Mercer Island, WA
National Provider Identifier
1023069317
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD00037546 Issued in WA
Practice address
7707 SE 27TH St
#104
Mercer Island, WA 98040-2844
Phone
(206) 275-3588
Fax
(206) 275-2073
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD00037546 WA Primary

Addresses

Primary practice location

7707 SE 27TH St
#104
Mercer Island, WA 98040-2844

Mailing address

7707 SE 27TH St
#104
Mercer Island, WA 98040-2844
Phone (206) 275-3588

Other practice location 1

751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201
Phone (425) 394-0700

Other identifiers 1

IdentifierTypeStateIssuer
8254260MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmittal1042552@wm.providencedirect.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907001092 WA Practitioner - Internal Medicine 1153353438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

751 NE Blakely Dr
Suite 5010
Issaquah, WA 98029-6201
Phone (425) 394-0700

Hospital & facility affiliations

  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00037546WAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Aug 30, 2013 Accepting new patients
Swedish Health Services CurrentSince Aug 30, 2013 Accepting new patients
John H. Addison MD PS Geriatric Medicine CurrentSince Oct 1, 2004 Accepting new patients
Overlake Medical Clinics LLC Past Accepting new patients
Overlake Medical Clinics, LLC PastSince Oct 1, 2004 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Ste 5010
Issaquah, WA 98029
Phone (425) 394-0700

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

7707 SE 27th St
Ste 110
Mercer Island, WA 98040
Phone (206) 275-3588

9725 SE 36th St
Ste 214
Mercer Island, WA 98040
Phone (206) 275-3588

7707 SE 27th St
Ste 104
Mercer Island, WA 98040
Phone (206) 232-2267

7707 SE 27th St
Ste 111
Mercer Island, WA 98040
Phone (206) 275-3588

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

Organizations & group practices 7

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 6

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1023069317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7707 SE 27TH ST",
            "address_2": "#104",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402844",
            "telephone_number": "206-275-3588",
            "fax_number": "206-275-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 SE 27TH ST",
            "address_2": "#104",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402844",
            "telephone_number": "206-275-3588",
            "fax_number": "206-275-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 5010",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "425-394-0700",
            "fax_number": "425-394-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "NEETI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00037546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8254260",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmittal1042552@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr Ste 5010",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

Verify at the official NPI Registry.