Shyamal K Mitra, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

0035439 Issued in NC

Practice address

3280 Henderson Dr Ste C
Jacksonville, NC 28546-5290

Phone

(910) 915-8450

Fax

(888) 745-7026

NPI assigned

Dec 7, 2005

Last updated

Aug 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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)Also: Internal Medicine, Nuclear Medicine, Peripheral Vascular Disease

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Cardiology Sleep and Obesity Center PCGroup PAC ID 7719106186, 3 clinicians

Onslow Memorial Hospital IncGroup PAC ID 1456252899, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042
• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: regionalhealthdiagnostics.shyamalmitra@117073.advancedmd-direct.com
• Direct secure messaging: shyamal.mitra@3530.securemail.prognocis.com

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.

• Carolina Cardiology, Sleep & Obesity Center PC

  • Internal Medicine Physician
  • Jacksonville, NC
  • NPI 1518397587

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD Authorized official
• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Medicare reassignment Care Compare group NPD
• Carolina Clinic for Health and Wellness PA

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1679998348

  Cardiovascular Disease

  Medicare reassignment NPD
• Cogent Healthcare of North Carolina, PC

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1548207483
  Medicare reassignment NPD
• Cumberland Cardiology, P.a.

  • Interventional Cardiology Physician
  • Fayetteville, NC
  • NPI 1386827574
  Medicare reassignment NPD
• East Carolina University

  dba ECU Physicians

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of North Carolina PLLC

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1164724902
  Medicare reassignment NPD
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• Kinston Medical Specialists PA

  • Internal Medicine Physician
  • Kinston, NC
  • NPI 1114904927

  Cardiovascular Disease

  NPD
• USA Sleep Diagnostic Mobile Service

  • Sleep Disorder Diagnostic Clinic/Center
  • Fayetteville, NC
  • NPI 1225493869
  NPD
• USA Sleep Diagnostic Mobile Service

  • Sleep Disorder Diagnostic Clinic/Center
  • Columbus, GA
  • NPI 1891449609
  NPD
• Price Eye Clinic PA

  • Ophthalmology Physician
  • Jacksonville, NC
  • NPI 1558306365
  NPD (past)

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

• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Regional Medical Center

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation
• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Care Compare affiliation
• Pitt County Memorial Hospital Inc

  dba ECU Health Beaufort Hospital-a campus of ECU Health Medical Center

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  dba ECU Health Medical Center

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1467437079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465290",
            "telephone_number": "910-915-8450",
            "fax_number": "888-745-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465290",
            "telephone_number": "910-915-8450",
            "fax_number": "888-745-7026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1136 Hwy 258 N Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285048304",
            "country_code": "US",
            "telephone_number": "910-915-8450",
            "fax_number": "888-745-7026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITRA",
        "first_name": "SHYAMAL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-08-02",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "0035439",
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NC",
            "license": "0035439",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NC",
            "license": "0035439",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NC",
            "license": "00-35439",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8959825",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060030036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "59825",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackalyn Lee Mitchell, RN, OGNP
• Kelly Mitchell
• Mark Anthony Mitchell, IDC
• Megan Irene Mitchell, FNP
• Whitney Carraway Mitchell, DMD
• Madhur Mittal, MD
• Alexandra Mocarski
• Sarah M Moffett
• Mograyson Inc
• Moments Matter Therapy PLLC

• Cardiovascular Disease Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.