Active NPI
Pradip K Mistry, MD
- Otolaryngology Physician
- Norfolk, NE
National Provider Identifier
1194747048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 16838
- Practice address
- 109 N 29TH St
Norfolk, NE 68701-3261 - Phone
- (402) 379-1704
- Fax
- (402) 379-4531
- NPI assigned
- Jul 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 16838 | NE | Primary |
Addresses
Primary practice location
109 N 29TH St
Norfolk, NE 68701-3261
Mailing address
109 N 29TH St
Norfolk, NE 68701-3261
Phone (402) 379-1704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3789 | Other | NE | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16838 | NE | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194747048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N 29TH ST",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687013261",
"telephone_number": "402-379-1704",
"fax_number": "402-379-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N 29TH ST",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687013261",
"telephone_number": "402-379-1704",
"fax_number": "402-379-4531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTRY",
"first_name": "PRADIP",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NE",
"license": "16838",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3789",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.