Michael Sumner Mitnik, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

NM84223 Issued in NM

Practice address

4801 McMahon Blvd NW Suite 155
Albuquerque, NM 87114

Phone

(505) 893-2880

Fax

(505) 893-2886

NPI assigned

Aug 5, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538178736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 MCMAHON BLVD NW SUITE 155",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-893-2880",
            "fax_number": "505-893-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MCMAHON BLVD NW SUITE 155",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-893-2880",
            "fax_number": "505-893-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITNIK",
        "first_name": "MICHAEL",
        "middle_name": "SUMNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "NM84223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33589",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruston Mitchell, LCSW
• Sarah G Mitchell, LISW
• Stephanie Mitchell
• William J Mitchell, M.D.
• William McRae Mithoefer, PA-C
• Sydney Mitsui
• Pradeep Mitta, MD
• Aditi Mittal, MD
• Vipin Mittal
• Henry Lawrance Mittleman, DPM

• Orthopaedic Surgery Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Orthopaedic Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.