Dean Cory Mitchell, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

170802 Issued in NY

Practice address

57 W 57TH St Ste 601
New York, NY 10019-2802

Phone

(212) 397-0157

Fax

(212) 586-6880

NPI assigned

Jan 16, 2007

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

Other identifiers 1

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.

Opted out of Medicare

Yes, effective Dec 29, 2015 through Dec 29, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mitchell Medical Group of New York PC

  • Allergy & Immunology (Internal Medicine) Physician
  • New York, NY
  • NPI 1609116565
  NPD (past) Authorized official
• Israel S Eckman MD PLLC

  • Dermatology Physician
  • Rockville Centre, NY
  • NPI 1750667952
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1255482295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 NORTH VIALLGE AVENUE",
            "address_2": "SUITE #129",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-678-9600",
            "fax_number": "516-678-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 601",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "212-397-0157",
            "fax_number": "212-586-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DEAN",
        "middle_name": "CORY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "170802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "261707718",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Mix Mitchell
• Cheryl Lynn Mitchell
• Chinetta Mitchell, LMSW
• Danica Mitchell, LMSW
• Dawn Mitchell, PSY.D
• Donald G Mitchell, P.A.
• Drew James Mitchell, PA-C
• Eric Ray Mitchell, M.D.
• Gabrielle Perris Mitchell, RN
• Gerald M Mitchell, DC

• Allergy & Immunology Physician in New York, NY
• Providers in New York, NY by specialty
• Allergy & Immunology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.