Individual provider Active NPI

Mita Panchal, M.D.

  • Hospitalist Physician
  • Walnut Creek, CA
National Provider Identifier
1245526391
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A131129 Issued in CA
Practice address
1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Phone
(925) 947-3393
Fax
(925) 947-3396
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X A131129 CA Primary

Addresses

Primary practice location

1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501

Mailing address

Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828

Other identifiers 1

IdentifierTypeStateIssuer
P01497419OtherCARAILROAD MEDICARE

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
I20150514000657 CA Practitioner - Internal Medicine 1052631033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2700 Grant St
Suite 200
Concord, CA 94520-2270
Phone (925) 674-0500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A131129CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Hospitalist Current Accepting new patients
John Muir Trauma Physicians Billing Service CurrentSince Apr 3, 2017 Accepting new patients
John Muir Physician Network CurrentSince Feb 28, 2015 Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

2700 Grant St
Ste 200
Concord, CA 94520
Phone (925) 674-2609

2540 East St
Concord, CA 94520
Phone (925) 674-2228

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

1220 Rossmoor Pkwy
Walnut Creek, CA 94595
Phone (925) 947-3393

Interoperability endpoints

  • Direct secure messaging: mpanchal33082@ehr.johnmuirhealth.com

Organizations & group practices 5

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 2

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1245526391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952501",
            "telephone_number": "925-947-3393",
            "fax_number": "925-947-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "MITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A131129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01497419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.