NPIMap

Individual provider Active NPI

Mitch Corley Calmer

  • Physician Assistant
  • New York, NY
National Provider Identifier
1265801989
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
301 E 17TH St
New York, NY 10003-3804
Phone
(212) 598-2449
NPI assigned
Sep 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

301 E 17TH St
New York, NY 10003-3804

Mailing address

1254 Pine Edge Dr
La Habra, CA 90631-8506
Phone (562) 631-9910

Other practice location 1

1254 Pine Edge Dr
La Habra, CA 90631-8506
Phone (562) 631-9910

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcalmer346551@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160512001823 CA Practitioner - Physician Assistant 1153610266 Reassigns benefits to 1 organization
I20210901002793 NY Practitioner - Physician Assistant 1153610266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

16 TH St and 1St Ave
New York, NY 10003-3804
Phone (212) 420-2000

301 E 17TH St
New York, NY 10003-3804
Phone (212) 263-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53100CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Apr 11, 2016 Accepting new patients
County of Ventura Current Accepting new patients
County of Ventura Current Accepting new patients
New York University CurrentSince Aug 1, 2021 Accepting new patients
New York University CurrentSince Aug 1, 2021 Accepting new patients

Locations

800 S Victoria Ave
#L4640
Ventura, CA 93009

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

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 7

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": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1265801989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 PINE EDGE DR",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906318506",
            "telephone_number": "562-631-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-2449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1254 Pine Edge Dr",
            "address_purpose": "LOCATION",
            "city": "La Habra",
            "state": "CA",
            "postal_code": "906318506",
            "country_code": "US",
            "telephone_number": "562-631-9910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALMER",
        "first_name": "MITCH",
        "middle_name": "CORLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-23",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcalmer346551@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "301 E 17th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100033804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.