Individual provider Active NPI

Anuj H Mittal, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Medford, OR
National Provider Identifier
1336317775
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD165996 Issued in OR
Practice address
2825 E Barnett Rd
Medford, OR 97504-8332
Phone
(541) 789-7000
NPI assigned
Feb 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301090915 MI
Pulmonary Disease Physician 207RP1001X MD165996 OR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD165996 OR Primary

Addresses

Primary practice location

2825 E Barnett Rd
Medford, OR 97504-8332

Mailing address

2620 E Barnett Rd Ste H
Medford, OR 97504-8383
Phone (541) 789-4281

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amittal981674@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20140702002083 OR Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 0446475693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

555 Black Oak Dr
Medford, OR 97504-8491

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090915MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2620 E Barnett Rd
Ste H
Medford, OR 97504
Phone (541) 789-4281

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

Interoperability endpoints

  • Direct secure messaging: amittal981674@oc.providencedirect.org

Organizations & group practices 1

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": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1336317775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD STE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "ANUJ",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301090915",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD165996",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD165996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amittal981674@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1698 E McAndrews Rd Ste 400",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975045590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.