Individual provider Active NPI

Mithu Chaudhury, DO

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1245650266
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R8329 Issued in TX
Practice address
324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885
Phone
(801) 408-8500
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10722408-1204 UT
Psychiatry Physician 2084P0800X R8329 TX Primary

Addresses

Primary practice location

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-4314

Other practice location 2

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 970-7000

Other practice location 3

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20191127001355 TX Practitioner - Psychiatry 3870899248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Arizona College of Osteopathic Medicine Mid Western University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Harris Center for Mental Health and IddGroup PAC ID 9739088790, 122 clinicians

Practice addresses (Care Compare)

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 970-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8329TXMDPsychiatry Physician
10722408-1204UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Harris Center for Mental Health and Idd CurrentSince Nov 11, 2019 Accepting new patients

Locations

9401 Southwest Fwy
Houston, TX 77074
Phone (713) 970-3344

1502 Taub Loop
Houston, TX 77030
Phone (713) 873-4900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1245650266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE STE 178",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032885",
            "telephone_number": "801-408-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-675-4314",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1502 Taub Loop",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301608",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741407",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUDHURY",
        "first_name": "MITHU",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "10722408-1204",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R8329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.