Mithun Gopal Devraj, M.D

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

23303 Issued in NV

Practice address

1600 Medical Pkwy
Carson City, NV 89703-4625

Phone

(775) 445-8000

NPI assigned

Jun 26, 2015

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carson Tahoe Physician ClinicsGroup PAC ID 1153479027, 104 clinicians

CTH Physicians ClinicGroup PAC ID 1254787203, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
• Carson Valley Health Hospital, Gardnerville, NV, CCN 291306
• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdevraj641637@direct.med.utah.edu

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.

• Carson Tahoe Physician Clinics

  • Internal Medicine Physician
  • Carson City, NV
  • NPI 1023265717
  Medicare reassignment Care Compare group NPD
• CTH Physicians Clinic

  • Internal Medicine Physician
  • Carson City, NV
  • NPI 1306533732
  Medicare reassignment Care Compare group NPD
• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Medicare reassignment NPD
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba CVMC Outpatient Behavioral Health Clinic

  • Community/Behavioral Health Agency
  • Gardnerville, NV
  • NPI 1104482918

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba Carson Valley Health

  • Critical Access Hospital
  • Gardnerville, NV
  • NPI 1396799102
  Care Compare affiliation
• Barton Healthcare System

  dba Barton Memorial Hospital

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1396127205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034625",
            "telephone_number": "775-445-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034625",
            "telephone_number": "775-445-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 23rd St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200372342",
            "country_code": "US",
            "telephone_number": "202-715-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Irving St NW Dept Of",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-8278",
            "fax_number": "202-877-6292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVRAJ",
        "first_name": "MITHUN",
        "middle_name": "GOPAL",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NV",
            "license": "23303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Bloom Pediatrics
• Desert Sage Medical
• Desert Valley Family Practice
• Rachael Desmidt
• Laura Ann Deverse, R.D.
• Kathleen Dewinter
• Charles Di Leonardo, MSPAS, PA-C
• Breanna D Di Pinto, APRN
• Diagnostic Pathology Medical Group, Inc.
• Dialysis Clinic Inc

• Interventional Cardiology Physician in Carson City, NV
• Providers in Carson City, NV by specialty
• Interventional Cardiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.