Individual provider Active NPI

Dimitra Mitsani, MD

  • Infectious Disease Physician
  • Baltimore, MD
National Provider Identifier
1467615500
Registry record updated Jan 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
D70785 Issued in MD
Practice address
821 N Eutaw St
Suite 308
Baltimore, MD 21201-4648
Phone
(410) 383-2072
Fax
(410) 383-0054
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MT190016 PA
Infectious Disease Physician 207RI0200X D70785 MD Primary

Addresses

Primary practice location

821 N Eutaw St
Suite 308
Baltimore, MD 21201-4648

Mailing address

821 N Eutaw St
Suite 308
Baltimore, MD 21201-4648
Phone (410) 383-2072

Other identifiers 1

IdentifierTypeStateIssuer
901901400MedicaidMD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D70785MDMDInfectious Disease Physician
MT190016PAMDInfectious Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357430400000",
    "number": "1467615500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST",
            "address_2": "SUITE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014648",
            "telephone_number": "410-383-2072",
            "fax_number": "412-648-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N EUTAW ST",
            "address_2": "SUITE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014648",
            "telephone_number": "410-383-2072",
            "fax_number": "410-383-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSANI",
        "first_name": "DIMITRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2013-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MT190016",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MD",
            "license": "D70785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "901901400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2013; 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.