NPIMap

Individual provider Active NPI

Mitchell Gershten, M.D.

  • Internal Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1104881077
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29583 Issued in CO
Practice address
2635 N 7TH St
Suite 4205
Grand Junction, CO 81501-8209
Phone
(970) 298-1995
Fax
(970) 298-1992
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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 29583 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Suite 4205
Grand Junction, CO 81501-8209

Mailing address

2635 N 7TH St Ste 4205
PO Box 62
Grand Junction, CO 81501-8209
Phone (970) 298-1995

Other identifiers 2

IdentifierTypeStateIssuer
1275714081MedicaidUT
01295831MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090211000176 CO Practitioner - Internal Medicine 1759274400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29583COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospital and Medical Center, Inc Internal Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Sep 8, 2008 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Sep 8, 2008 Accepting new patients
St. Mary'S Hospital and Medical Center, Inc. Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

2635 N 7th St
Ste 4205
Grand Junction, CO 81501
Phone (970) 298-7049

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

Organizations & group practices 6

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 4

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1104881077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST STE 4205",
            "address_2": "PO BOX 62",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-1995",
            "fax_number": "970-298-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "address_2": "SUITE 4205",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-1995",
            "fax_number": "970-298-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHTEN",
        "first_name": "MITCHELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "29583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275714081",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01295831",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.