Kunal Mitra, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35052774M Issued in OH

Practice address

970 E Washington St Ste 2F
Medina, OH 44256

Phone

(330) 723-7999

NPI assigned

Oct 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• A & S Khandelwal MD Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Medina, OH
  • NPI 1487702718
  Medicare reassignment NPD
• Kunal Mitra MD

  • Internal Medicine Physician
  • Medina, OH
  • NPI 1922263573
  NPD (past) Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1538254271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST STE 2F",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562181",
            "telephone_number": "330-723-7999",
            "fax_number": "330-764-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST STE 2F",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "44256",
            "telephone_number": "330-723-7999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3575 Reserve Commons Dr",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "44256",
            "country_code": "US",
            "telephone_number": "330-725-1000",
            "fax_number": "330-725-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITRA",
        "first_name": "KUNAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35052774M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0709559",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Mirabella, DPT
• Igor Miroshnichenko
• Cheryl Lynn Mitchell, LPCC-S
• Jessica Ellen Mitchell
• Lana Mitchell
• Samantha Moats
• Moe and Helpers
• Mohan Kareti Inc
• Terry Lee Moles
• Caroline Molony, PMHNP

• Internal Medicine Physician in Medina, OH
• Providers in Medina, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.