NPIMap

Individual provider Active NPI

Matthew Lee Mitchell, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1104125657
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
01076800A Issued in IN
Practice address
8330 Naab Rd Ste 340
Indianapolis, IN 46260-2279
Phone
(317) 338-5100
NPI assigned
Mar 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01076800A IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01076800A IN Primary

Addresses

Primary practice location

8330 Naab Rd Ste 340
Indianapolis, IN 46260-2279

Mailing address

250 W 96TH St # 520
Indianapolis, IN 46260-1316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160510002105 IN Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 5698907525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Emergency Medicine
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

10580 N Meridian St
Carmel, IN 46290-1028
Phone (317) 583-5000

10590 N Meridian St
Carmel, IN 46290-1028

13500 N Meridian St
Carmel, IN 46032-1456
Phone (317) 582-7000

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • St Vincent Heart Center Hospital, Carmel, IN, CCN 150153
  • Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01076800AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
St. Vincent Medical Group, Inc. Emergency Medicine CurrentSince Dec 2, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Dec 2, 2018 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8330 Naab Rd
Ste 340
Indianapolis, IN 46260
Phone (317) 338-5100

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

8333 Naab Rd
Ste 250
Indianapolis, IN 46260
Phone (317) 338-5100

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 9

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 5

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1104125657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST # 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 NAAB RD STE 340",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602279",
            "telephone_number": "317-338-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01076800A",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01076800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.