NPIMap

Individual provider Active NPI

Marat Mitelman, MD

  • Internal Medicine Physician
  • Lansdale, PA
National Provider Identifier
1295399913
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD488054 Issued in PA
Practice address
1970 North Broad Street
Lansdale, PA 19446-1002
Phone
(215) 368-1900
Fax
(215) 368-8772
NPI assigned
Apr 29, 2019
Reactivated
Jun 12, 2023
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD488054 PA Primary

Addresses

Primary practice location

1970 North Broad Street
Lansdale, PA 19446-1002

Mailing address

1970 North Broad Street
Lansdale, PA 19446-1002
Phone (215) 368-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, PA2 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
I20230714003479 VT Practitioner - Internal Medicine 8224498704 Reassigns benefits to 1 organization
I20250502001959 PA Practitioner - Internal Medicine 8224498704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

824 Main St
Phoenixville, PA 19460-4478

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center Inc. Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Aug 1, 2023 Accepting new patients
Clinical Care Associates of the University of CurrentSince Jun 24, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jun 24, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Southwestern Vermont Medical Center, Inc Past Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients

Locations

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

140 Hospital Dr
Bennington, VT 05201
Phone (802) 442-3520

140 Hospital Dr
Ste 108
Bennington, VT 05201
Phone (802) 447-1191

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1295399913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 NORTH BROAD STREET",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461002",
            "telephone_number": "215-368-1900",
            "fax_number": "215-368-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 NORTH BROAD STREET",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461002",
            "telephone_number": "215-368-1900",
            "fax_number": "215-368-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITELMAN",
        "first_name": "MARAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "deactivation_date": "2023-05-22",
        "reactivation_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD488054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.