Individual provider Active NPI

Marc A Mitchell, DO

  • Urology Physician
  • Silverdale, WA
National Provider Identifier
1265620363
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OP60085623 Issued in WA
Practice address
9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505
Phone
(360) 782-3222
Fax
(360) 782-3245
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101016185 MI
Urology Physician 208800000X OP60085623 WA Primary

Addresses

Primary practice location

9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502

Other practice location 1

19245 7th Ave NE
Poulsbo, WA 98370-6551
Phone (360) 782-3500

Other identifiers 2

IdentifierTypeStateIssuer
1010MIOtherWAREGENCE
249177OtherWALABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20090706000477 WA Practitioner - Urology 3375694227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
College of Osteo Med of the Pacific at Pomona, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505
Phone (360) 782-3200

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016185MIMDUrology Physician
OP60085623WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

450 S Kitsap Blvd
Ste 250
Port Orchard, WA 98366
Phone (360) 782-3000

19245 7th Ave NE
Poulsbo, WA 98370
Phone (360) 782-3500

19245 7th Ave NE
#O
Poulsbo, WA 98370
Phone (360) 782-3500

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

9398 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3200

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

9398 Ridgetop Blvd NW
#O
Silverdale, WA 98383
Phone (360) 782-3200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: marc.mitchell@tdc.directbygreenway.com

Organizations & group practices 4

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265620363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9398 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838505",
            "telephone_number": "360-782-3222",
            "fax_number": "360-782-3245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19245 7th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Poulsbo",
            "state": "WA",
            "postal_code": "983706551",
            "country_code": "US",
            "telephone_number": "360-782-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2023-03-07",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101016185",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "OP60085623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1010MI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "249177",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.