Individual provider Active NPI

Ronald Alvin Mitchell, MD

  • Internal Medicine Physician
  • Mountt Vernon, NY
National Provider Identifier
1154556736
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2509111 Issued in NY
Practice address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mountt Vernon, NY 10550
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
May 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2509111 NY Primary
Internal Medicine Physician 207R00000X 250911-1 NY

Addresses

Primary practice location

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mountt Vernon, NY 10550

Mailing address

107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mt Vernon, NY 10550
Phone (914) 699-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120220000305 NY Practitioner - Internal Medicine 9638222722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250911-1NYMDInternal Medicine Physician
2509111NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Jan 8, 2012 Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Jan 8, 2012 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 3

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1154556736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNTT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RONALD",
        "middle_name": "ALVIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2509111",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "250911-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.