Priyanka Reddy Mitta, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

MT232288 Issued in PA

Practice address

501 Bath Rd
Bristol, PA 19007-3190

Phone

(215) 785-9200

NPI assigned

Jun 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1356182802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BATH RD",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190073190",
            "telephone_number": "215-785-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BATH RD",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190073190",
            "telephone_number": "215-785-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTA",
        "first_name": "PRIYANKA REDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT232288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midatlantic Cardiothoracic & Vascular Assoc
• Jarrett Miller, LPC
• Stephanie Christine Miller, COTA
• Mind Flex LLC
• Julie Ann Mitchell
• Arushi Mohan
• Talha Mohiu Din
• Tamara Diane Monroe, BSC
• Mark C Montag, MD
• Jessica Mount

• Student in an Organized Health Care Education/Training Program in Bristol, PA
• Providers in Bristol, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.