Individual provider Active NPI

Mitchell H Paulin, MD

  • Physical Medicine & Rehabilitation Physician
  • Paoli, PA
National Provider Identifier
1306930243
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD041363L Issued in PA
Practice address
21 Industrial Blvd Ste 102
Paoli, PA 19301-1610
Phone
(610) 640-7434
Fax
(610) 640-7436
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD041363L PA Primary

Addresses

Primary practice location

21 Industrial Blvd Ste 102
Paoli, PA 19301-1610

Mailing address

21 Industrial Blvd Ste 102
Paoli, PA 19301-1610
Phone (610) 640-7434

Other identifiers 1

IdentifierTypeStateIssuer
0000916701MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050510000690 PA Practitioner - Physical Medicine and Rehabilitation 3678562089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates of the Main Line, P.C.Group PAC ID 8325037724, 14 clinicians

Practice addresses (Care Compare)

414 Paoli Pike
Malvern, PA 19355-3311
Phone (484) 596-5254

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of the Main Line, P.C. Physical Medicine & Rehabilitation CurrentSince Mar 13, 1998 Accepting new patients
Medical Associates of the Main Line, PC PastSince Mar 12, 2024 Accepting new patients
Rehabilitation Associates of the Main Line PastSince Apr 11, 2021 Accepting new patients

Locations

414 Paoli Pike
Malvern, PA 19355
Phone (484) 596-5254

21 Industrial Blvd
Ste 102
Paoli, PA 19301
Phone (610) 640-3920

Interoperability endpoints

  • Direct secure messaging: mitchell.paulin.1@554.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1306930243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 INDUSTRIAL BLVD STE 102",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011610",
            "telephone_number": "610-640-7434",
            "fax_number": "610-640-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 INDUSTRIAL BLVD STE 102",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011610",
            "telephone_number": "610-640-7434",
            "fax_number": "610-640-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULIN",
        "first_name": "MITCHELL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD041363L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000916701",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.