Individual provider Active NPI

Mitchell R Humphreys, M.D.

  • Urology Physician
  • Phoenix, AZ
National Provider Identifier
1144208430
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
32284 Issued in AZ
Practice address
5779 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone
(480) 301-8000
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 43672 MN
Urology Physician 208800000X 32284 AZ Primary

Addresses

Primary practice location

5779 E Mayo Blvd
Phoenix, AZ 85054-4502

Mailing address

5779 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhumphreys394772@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20060412000361 AZ Practitioner - Urology 5799794152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Missouri, Columbia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

5701 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-4200

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

5779 E Mayo Blvd
Speciality Building
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection223

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Jul 1, 2006 Accepting new patients
Mayo Clinic Arizona CurrentSince Jul 1, 2006 Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

5779 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-0865

13400 E Shea Blvd
Scottsdale, AZ 85259

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mhumphreys394772@ehrdirect.mayoclinicmsg.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayo Clinic HospitalPhoenix, AZ, CCN 030103 Hospital Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1144208430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5779 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5779 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "MITCHELL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "43672",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "32284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhumphreys394772@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5779 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.