Individual provider Active NPI

Amit Mittal, MD

  • Cardiovascular Disease Physician
  • Northport, NY
National Provider Identifier
1134324494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Practice address
79 Middleville Rd
Northport, NY 11768-2200
Phone
(631) 261-4400
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NY Primary

Addresses

Primary practice location

79 Middleville Rd
Northport, NY 11768-2200

Mailing address

39 Commodore Cir
Port Jefferson Station, NY 11776-2258
Phone (631) 261-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20090814000225 MD Practitioner - Cardiovascular Disease (Cardiology) 5597819284 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Meharry Medical College School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

826 Washington Rd
Westminster, MD 21157-5780
Phone (410) 876-9111

Hospital & facility affiliations

  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033

Merit-based Incentive Payment System (MIPS)

Final score
21.15 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
390200000XNYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc CurrentSince Oct 17, 2011 Accepting new patients
Lifebridge Community Physicians Inc Cardiovascular Disease CurrentSince Oct 17, 2011 Accepting new patients
Lifebridge Community Physicians, Inc Cardiovascular Disease Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

193 Stoner Ave
Ste 340
Westminster, MD 21157
Phone (410) 871-9800

826 Washington Rd
Ste 215
Westminster, MD 21157
Phone (410) 876-1633

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

Organizations & group practices 5

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 1

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134324494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COMMODORE CIR",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762258",
            "telephone_number": "631-261-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "AMIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.