NPIMap

Individual provider Active NPI

Chetan Amritlal Mistry, MD

  • Pediatrics Physician
  • Chula Vista, CA
National Provider Identifier
1467505834
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A97646 Issued in CA
Practice address
865 3Rd Ave Ste 101
Chula Vista, CA 91911-1349
Phone
(619) 426-7910
Fax
(619) 426-4953
NPI assigned
Jan 19, 2007
Last updated
Feb 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A97646 CA Primary

Addresses

Primary practice location

865 3Rd Ave Ste 101
Chula Vista, CA 91911-1349

Mailing address

865 3Rd Ave Ste 101
Chula Vista, CA 91911-1349
Phone (619) 426-7910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97646CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cmistry11594@radychildrens.direct-ci.com
  • Direct secure messaging: cmistry80461@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1467505834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 3RD AVE STE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111349",
            "telephone_number": "619-426-7910",
            "fax_number": "619-426-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 3RD AVE STE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111349",
            "telephone_number": "619-426-7910",
            "fax_number": "619-426-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "CHETAN",
        "middle_name": "AMRITLAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.