Organization Active NPI

Mitta Primary Care

  • Family Medicine Physician
  • Ocala, FL
National Provider Identifier
1346655040
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME95726 Issued in FL
Legal business name
MITTA PRIMARY CARE
Practice address
9401 SW Highway 200
Building 700, Suite 701
Ocala, FL 34481-9612
Phone
(352) 873-0501
Fax
(352) 873-0502
NPI assigned
Jun 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Authorized official

Name
Dr. Walter Mitta, MDNPI 1932134731
Title
Internal Medicine
Phone
(352) 873-0501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME95726 FL Primary

Addresses

Primary practice location

9401 SW Highway 200
Building 700, Suite 701
Ocala, FL 34481-9612

Mailing address

9401 SW Highway 200
Building 700, Suite 701
Ocala, FL 34481-9612
Phone (352) 873-0501

Other identifiers 1

IdentifierTypeStateIssuer
277425900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140912000157 FL Part B Supplier - Clinic/Group Practice 2264651918 Receives reassigned benefits from 1 practitioner
Practice locations: Ocala, FL

National Provider Directory

National Provider Directory

Locations

9401 SW Highway 200
Ste 701
Ocala, FL 34481
Phone (352) 873-0501

9401 SW Highway 200
Bldg 700
Ocala, FL 34481
Phone (352) 861-6633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1346655040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 SW HIGHWAY 200",
            "address_2": "BUILDING 700, SUITE 701",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344819612",
            "telephone_number": "352-873-0501",
            "fax_number": "352-873-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW HIGHWAY 200",
            "address_2": "BUILDING 700, SUITE 701",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344819612",
            "telephone_number": "352-873-0501",
            "fax_number": "352-873-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITTA PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "MITTA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "INTERNAL MEDICINE",
        "authorized_official_telephone_number": "352-873-0501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277425900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.