Mark William Mittauer, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME48585 Issued in FL

Practice address

Rte 12 BLDG 449
Groton, CT 06349-5600

Phone

(860) 694-2377

Fax

(860) 694-2590

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Psychiatry

Education

University of Virginia School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abbe Management CorpGroup PAC ID 0446140222, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmittauer1021422@direct.unitypoint.org

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.

• Abbe Management Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hiawatha, IA
  • NPI 1811998859
  Medicare reassignment Care Compare group NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1255322996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RTE 12 BLDG 449",
            "address_2": "ATTN: PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RTE 12 BLDG 449",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAUER",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME48585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennette Miller
• Matthew Braden Burns Miller, DDS
• Renay Miller, BSC(PHARMACY)
• Dawn Mingione, M.S. CCC-SLP
• Matthew John Mitchell, IDC
• Edward Thomas Moldenhauer, RPH (MS BPHARM)
• Amy L Moncy, CCC-SLP
• Kristin Montgomery
• Matthew Isiah Morrison
• Austin Shane Morrow, SUBFOR IDC

• Psychiatry Physician in Groton, CT
• Providers in Groton, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.