Individual provider Active NPI

Michael Mostyn, M.D.

  • Internal Medicine Physician
  • Palm Desert, CA
National Provider Identifier
1235166059
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A37252 Issued in CA
Practice address
74990 Country Club Dr
Suite # 310
Palm Desert, CA 92260-1991
Phone
(760) 341-8800
Fax
(760) 775-4818
NPI assigned
Jun 27, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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 A37252 CA Primary

Addresses

Primary practice location

74990 Country Club Dr
Suite # 310
Palm Desert, CA 92260-1991

Mailing address

81767 Dr Carreon Blvd
Suite #201
Indio, CA 92201-5597
Phone (760) 775-4181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081126000451 CA Practitioner - Internal Medicine 3971663592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coachella Valley Care Medical Associates IncGroup PAC ID 2961627286, 3 clinicians

Practice addresses (Care Compare)

1293 6TH St
Coachella, CA 92236-1707
Phone (760) 775-4181

81709 Doctor Carreon Blvd
C3
Indio, CA 92201-5577
Phone (760) 775-4181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A37252CAMDInternal Medicine Physician
37252CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indio Emergency Med Group Inc CurrentSince Jan 19, 2017 Accepting new patients
Indio Emergency Medical Group Inc CurrentSince Jan 19, 2017 Accepting new patients
Coachella Valley Care Medical Associates Inc CurrentSince Feb 8, 2017 Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients
Indio Emergency Medical Group Past Accepting new patients
Coachella Valley Care Medical Associates Inc Past Accepting new patients

Locations

1293 6th St
Coachella, CA 92236
Phone (760) 391-5151

1293 6th St
#A
Coachella, CA 92236

81709 Doctor Carreon Blvd
Ste C3
Indio, CA 92201
Phone (760) 342-6404

81767 Doctor Carreon Blvd
Ste 201
Indio, CA 92201

41865 Boardwalk
Ste 103
Palm Desert, CA 92211
Phone (760) 340-2260

74990 Country Club Dr
Ste 310
Palm Desert, CA 92260
Phone (760) 341-8800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: michaelmostyn@iemg.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1235166059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81767 DR CARREON BLVD",
            "address_2": "SUITE #201",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015597",
            "telephone_number": "760-775-4181",
            "fax_number": "760-775-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74990 COUNTRY CLUB DR",
            "address_2": "SUITE # 310",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922601991",
            "telephone_number": "760-341-8800",
            "fax_number": "760-775-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTYN",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A37252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.