Active NPI
Swagata Mitra, M.D.
- Pediatrics Physician
- Dover, DE
National Provider Identifier
1538721113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C1-0025007
- Practice address
- 863 Buttner PL Ste 103
Dover, DE 19904-2406 - Phone
- (302) 734-3331
- NPI assigned
- Jul 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C1-0025007 | DE | Primary |
Addresses
Primary practice location
863 Buttner PL Ste 103
Dover, DE 19904-2406
Mailing address
863 Buttner PL Ste 103
Dover, DE 19904-2406
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| YJ61240B | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0025007 | DE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Health Services, Inc | Pediatrics | Past | Accepting new patients |
| Bayhealth Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Bayhealth Hospital, Kent Campus
- General Acute Care Hospital
- Dover, DE
- NPI 1467546135
-
dba CCHS Satellite Offices
- Family Medicine Physician
- Hockessin, DE
- NPI 1134104565
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1538721113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "863 BUTTNER PL STE 103",
"city": "DOVER",
"state": "DE",
"postal_code": "199042406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "863 BUTTNER PL STE 103",
"city": "DOVER",
"state": "DE",
"postal_code": "199042406",
"telephone_number": "302-734-3331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITRA",
"first_name": "SWAGATA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-03",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0025007",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "YJ61240B",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.