NPIMap

Individual provider Active NPI

Niraj Chimanbhai Mistry, MD

  • Internal Medicine Physician
  • Elyria, OH
National Provider Identifier
1528069952
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-075487 Issued in OH
Practice address
125 E Broad St
Suite 202
Elyria, OH 44035-6400
Phone
(440) 329-7306
Fax
(440) 329-7798
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-075487 OH Primary

Addresses

Primary practice location

125 E Broad St
Suite 202
Elyria, OH 44035-6400

Mailing address

125 E Broad St
Ste 202
Elyria, OH 44035-6400
Phone (440) 329-7305

Other identifiers 1

IdentifierTypeStateIssuer
2102450MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NirajMistry@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100122000169 OH Practitioner - Internal Medicine 4183764038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

125 E Broad St
Elyria, OH 44035-6429

125 E Broad St
Suite 218
Elyria, OH 44035-6447
Phone (440) 329-7310

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
  • O'Neill Healthcare - Hospice Hospice, Bay Village, OH, CCN 361666
  • Hospice of the Western Reserve at University Hosp Hospice, Cleveland, OH, CCN 361678
  • Hospice of the Western Reserve, Inc Hospice, Cleveland, OH, CCN 361503
  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
  • Life Care Center of Elyria Nursing home, Elyria, OH, CCN 366176
  • O'Neill Healthcare North Ridgeville Nursing home, North Ridgeville, OH, CCN 365685

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Mar 1, 2015 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Mar 1, 2015 Accepting new patients
Emh Professional Services Inc. Past Accepting new patients
Center Ridge Nursing Home, Inc. Past Accepting new patients
Lorain Medical Investors Limited Partnership Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

1997 Healthway Dr
Avon, OH 44011
Phone (440) 329-7720

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

125 E Broad St
Ste 202
Elyria, OH 44035
Phone (440) 329-7305

Interoperability endpoints

  • Direct secure messaging: nirajmistry@uhps.allscriptsdirect.net
  • Direct secure messaging: nmistry37209@ehrdirect.uhhospitals.org

Organizations & group practices 8

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1528069952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "STE 202",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7305",
            "fax_number": "440-329-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE 202",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7306",
            "fax_number": "440-329-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "NIRAJ",
        "middle_name": "CHIMANBHAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-075487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102450",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NirajMistry@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "125 E Broad St",
            "address_2": "Suite 202",
            "city": "Elyria",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440356400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.