Isaac Mittendorf, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41002 Issued in SC

Practice address

2331 New Holt Rd
Paducah, KY 42001-7404

Phone

(270) 441-4777

Fax

(270) 441-4780

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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 KY

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

Family Practice

Education

University of Kentucky College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Internal Medicine PLLCGroup PAC ID 9537392154, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Home Care Ky, LLC Dba Baptist Home Health Care Home health agency, Louisville, KY, CCN 187091
• Mercy Health - Home Care, Paducah Home health agency, Paducah, KY, CCN 187100
• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
• Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
• Massac Memorial Hospital Hospital, Metropolis, IL, CCN 141323
• Livingston Hospital and Healthcare Services, Inc Hospital, Salem, KY, CCN 181320

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: isaac.mittendorf.1@9112.direct.athenahealth.com

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.

• Advanced Internal Medicine PLLC

  • Internal Medicine Physician
  • Paducah, KY
  • NPI 1336563543
  Medicare reassignment Care Compare group NPD
• James Kyle Turnbo M.D. PSC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1457453540
  Medicare reassignment NPD
• Self Medical Group

  • Gastroenterology Physician
  • Greenwood, SC
  • NPI 1841047560
  NPD (past)

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

• Baptist Health Home Care Ky LLC

  • Home Health Agency
  • Paducah, KY
  • NPI 1780498030
  Care Compare affiliation
• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation
• Compassus BSMH Paducah HHA LLC

  • Home Health Agency
  • Paducah, KY
  • NPI 1235957168
  Care Compare affiliation
• Livingston Hospital and Healthcare Services, Inc.

  • Critical Access Hospital
  • Salem, KY
  • NPI 1588640254
  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Hospital

  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  Care Compare affiliation
• Massac Memorial Hospital

  • Critical Access Hospital
  • Metropolis, IL
  • NPI 1790788578
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1528595352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017404",
            "telephone_number": "270-441-4777",
            "fax_number": "270-441-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017404",
            "telephone_number": "270-441-4777",
            "fax_number": "270-441-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTENDORF",
        "first_name": "ISAAC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "41002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.