Individual provider Active NPI

Donald G. Mitchell, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1083630511
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD033867E Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-6226
Fax
(215) 955-5098
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD033867E PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

615 Chestnut St
14TH FLR., Central Enrollments
Philadelphia, PA 19106-4404

Other identifiers 2

IdentifierTypeStateIssuer
6378803MedicaidNJ
001048617MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040311000923 PA Practitioner - Diagnostic Radiology 5698664399 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD033867EPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince May 29, 2018 Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince Jul 1, 1999 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology Current Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Apr 29, 2018 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
800 Imaging Associates LLC CurrentSince Jan 1, 2006 Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients
Imaging Associates, PA Past Accepting new patients
Insight Health Corp PastSince Jul 24, 2020 Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

243 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (609) 680-9263

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

800 W State St
Ste 203
Doylestown, PA 18901
Phone (215) 345-4568

800 W State St
Doylestown, PA 18901
Phone (215) 340-1700

825 Town Center Dr
Ste 100
Langhorne, PA 19047
Phone (215) 750-1615

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

615 Chestnut St
Fl 14
Philadelphia, PA 19106
Phone (215) 955-1175

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Ste G3390
Philadelphia, PA 19107
Phone (215) 955-2900

301 Callowhill St
Philadelphia, PA 19123
Phone (215) 574-9400

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1083630511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CHESTNUT ST",
            "address_2": "14TH FLR., CENTRAL ENROLLMENTS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-955-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DONALD",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD033867E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6378803",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001048617",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.