NPIMap

Individual provider Active NPI

Michael David Mitchell, M.D.

  • Internal Medicine Physician
  • Alexandria, VA
National Provider Identifier
1235281783
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55657 Issued in VA
Practice address
4660 Kenmore Avenue, Suite 900
Alexandria, VA 22304-1383
Phone
(703) 461-0700
Fax
(703) 461-0803
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 55657 VA Primary

Addresses

Primary practice location

4660 Kenmore Avenue, Suite 900
Alexandria, VA 22304-1383

Mailing address

224 D Cornwall Street NW
Ste 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 2

IdentifierTypeStateIssuer
30016327500002MedicaidVA
1235281783MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090612000264 DC Practitioner - Internal Medicine 5991855967 Reassigns benefits to 1 organization
I20160315002182 VA Practitioner - Internal Medicine 5991855967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Practice addresses (Care Compare)

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

4660 Kenmore Ave
Suite 900
Alexandria, VA 22304-1383
Phone (703) 461-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55657VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC Internal Medicine CurrentSince Jan 30, 2016 Accepting new patients
Loudoun Medical Group, PC CurrentSince Jun 1, 2009 Accepting new patients
Loudoun Medical Group, PC CurrentSince Jun 1, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4660 Kenmore Ave
Ste 1210
Alexandria, VA 22304
Phone (703) 461-0700

4660 Kenmore Ave
Ste 900
Alexandria, VA 22304
Phone (703) 212-0700

6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700

5249 Duke St
Ste 100
Alexandria, VA 22304
Phone (703) 370-2814

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

Interoperability endpoints

  • Direct secure messaging: michael.mitchell@lmg1.eclinicaldirectplus.com

Organizations & group practices 4

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 4

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1235281783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 D CORNWALL STREET NW",
            "address_2": "STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVENUE, SUITE 900",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041383",
            "telephone_number": "703-461-0700",
            "fax_number": "703-461-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "55657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016327500002",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235281783",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.