Jacob Robert Mitchell

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

11018936A Issued in IN

Practice address

1120 W Michigan St
Gatch Hall Suite CL 627
Indianapolis, IN 46202-5209

Phone

(330) 807-8029

NPI assigned

Jun 16, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, OH2 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 2

Specialty

Diagnostic Radiology

Education

Wright State University Boonshoft School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
• Wyandot Memorial Hospital Hospital, Upper Sandusky, OH, CCN 361329
• Avita Ontario Hospital, Ontario, OH, CCN 360365
• Grady Memorial Hospital Hospital, Delaware, OH, CCN 360210

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmitchell1064490@direct.osumc.edu

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.

• Riverside Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1093718496

  PA

  Medicare reassignment Care Compare group NPD

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

• Avita Ontario Hospital

  • General Acute Care Hospital
  • Ontario, OH
  • NPI 1790131050
  Care Compare affiliation
• Grady Memorial Hospital

  • General Acute Care Hospital
  • Delaware, OH
  • NPI 1235174327
  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  Care Compare affiliation
• Ohiohealth Corporation

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1801937008
  Care Compare affiliation
• Wyandot Memorial Hospital

  • Critical Access Hospital
  • Upper Sandusky, OH
  • NPI 1477554475
  Care Compare affiliation

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1508216813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST",
            "address_2": "GATCH HALL SUITE CL 627",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "330-807-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST",
            "address_2": "GATCH HALL SUITE CL 627",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "330-807-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "11018936A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Lee Mitchell, D.D.S.
• Edward B Mitchell, D. MIN
• Gabrielle Mitchell
• Gene' Mitchell
• Grace Mitchell, LSW
• Jamie A Mitchell, PHYSICAL THERAPY AST
• Jan Mitchell, GRIEF COACH
• Jane S Mitchell, MD
• Jennifer E Mitchell, BSN CCRN RN
• Joanna Elaine Mitchell, NP

• Diagnostic Radiology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.