Individual provider Active NPI

Erica Leith Mitchell, MD

  • Vascular Surgery Physician
  • Portland, OR
National Provider Identifier
1417044462
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
63011 Issued in TN
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7810
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 73803 WI
Vascular Surgery Physician 2086S0129X MD24570 OR
Vascular Surgery Physician 2086S0129X 63011 TN Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3452 NW Vaughn St
Portland, OR 97210-1247

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Other practice location 2

262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, WI, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200812001253 WA Practitioner - Vascular Surgery 7113911082 Reassigns benefits to 2 organizations
I20200916000901 WI Practitioner - Vascular Surgery 7113911082 Reassigns benefits to 1 organization
I20210209003086 TN Practitioner - Vascular Surgery 7113911082 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Colorado School of Medicine, Aurora, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

406 S 30TH Ave
Suite 101
Yakima, WA 98902-3713
Phone (509) 248-7715

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

569 Skyline Dr
Jackson, TN 38301-3911
Phone (731) 421-6510

880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-6969

979 E 3Rd St
Chattanooga, TN 37403-2136
Phone (423) 778-5661

Hospital & facility affiliations

  • Regional One Health Hospital, Memphis, TN, CCN 440152
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 18, 2020 Accepting new patients
Erlanger Health CurrentSince Mar 1, 2026 Accepting new patients
Multicare Health System CurrentSince Oct 1, 2025 Accepting new patients
Erlanger Health CurrentSince Mar 1, 2026 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Feb 3, 2021 Accepting new patients
Multicare Health System CurrentSince Oct 1, 2025 Accepting new patients
West Tennessee Medical Group Inc CurrentSince Mar 29, 2024 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Sep 18, 2020 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Feb 3, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients

Locations

979 E 3rd St
Ste C520
Chattanooga, TN 37403
Phone (423) 778-4465

979 E 3rd St
Ste 300
Chattanooga, TN 37403
Phone (423) 757-0792

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

569 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

700 W Forest Ave
Ste 4
Jackson, TN 38301

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: emitchell25869@mlh.direct-ci.com

Organizations & group practices 12

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 4

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1417044462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 NW VAUGHN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972101247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "262 Danny Thomas Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381053678",
            "country_code": "US",
            "telephone_number": "901-595-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ERICA",
        "middle_name": "LEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "73803",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD24570",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "63011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.