Mario Mutic, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

257090 Issued in NY

Practice address

170 Maple Ave
Suite G1
White Plains, NY 10601-4710

Phone

(914) 683-0443

Fax

(914) 683-8620

NPI assigned

Mar 1, 2006

Last updated

Jan 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018
• Greenwich Woods Rehabilitation Nursing home, Greenwich, CT, CCN 075309
• The Enclave At Rye Rehab And Nursing Ctr Nursing home, Port Chester, NY, CCN 335312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: mario.mutic.1@21260.direct.athenahealth.com
• Direct secure messaging: mmutic@hiemail.healtheconnections.org

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.

• Westchester Medical Group, P.C.

  dba WESTMED Medical Group

  • Critical Care Medicine (Internal Medicine) Physician
  • Rye Brook, NY
  • NPI 1881653822

  CT

  Medicare reassignment Care Compare group NPD
• The Westchester Medical Group PC

  dba Westmed Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Greenwich, CT
  • NPI 1790560878
  NPD
• Maple Medical LLP

  • Pulmonary Disease Physician
  • White Plains, NY
  • NPI 1396717526

  Internal Medicine

  NPD (past)
• Maple Medical, LLP

  • Cardiovascular Disease Physician
  • White Plains, NY
  • NPI 1417100298
  NPD (past)
• Greenwich Hospital

  • General Acute Care Hospital
  • Greenwich, CT
  • NPI 1609846088
  NPD (past)

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

• Port Chester Operating LLC

  dba Port Chester Nursing & Rehab Center

  • Skilled Nursing Facility
  • Port Chester, NY
  • NPI 1154774271

  Nursing home

  Care Compare affiliation
• Greenwich Hospital

  • General Acute Care Hospital
  • Greenwich, CT
  • NPI 1609846088
  Care Compare affiliation
• Greenwich Woods Rehabilitation LLC

  dba Greenwich Woods Rehabilitation and Health Care Center

  • Skilled Nursing Facility
  • Greenwich, CT
  • NPI 1366840621

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1083681993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1722",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106021722",
            "telephone_number": "914-683-0443",
            "fax_number": "914-683-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MAPLE AVE",
            "address_2": "SUITE G1",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014710",
            "telephone_number": "914-683-0443",
            "fax_number": "914-683-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTIC",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "257090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009934086",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "257090",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "51531097",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "P00312169",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP",
            "identifier": "DB8444",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Patricia Murphy, COTA
• Alicia R Murray, D.O.
• Edward F Murray
• Mythili Murthy, M.D.
• Edmond Benedict Mustera, P.T.
• Allison Schecter Myers, DDS
• Yoojin NA, M.D.
• Sarah Leah Nachimson, PSYD
• Jessica Nacinovich, OT
• Michele Naclerio, M.S., CCC-SLP

• Internal Medicine Physician in White Plains, NY
• Providers in White Plains, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.