Individual provider Active NPI

Mitchel Ryan Corson, DO

  • Emergency Medicine Physician
  • Roseville, CA
National Provider Identifier
1245935741
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.OP.70086841 Issued in WA
Practice address
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone
(916) 781-1647
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO.OP.70086841 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Medical Plaza Dr
Roseville, CA 95661-3037

Mailing address

1 Medical Plaza Dr
Roseville, CA 95661-3037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

105 Webster Dr
Friday Harbor, WA 98250-8106

5000 Hopyard Rd
Suite 410
Pleasanton, CA 94588-3145

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mcorson655917@hisp.ehr.sutterhealth.org

Hospital & facility affiliations 1

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1245935741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613037",
            "telephone_number": "916-781-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "MITCHEL",
        "middle_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "DO.OP.70086841",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.