Kshitij P Mistry, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

2004-01098 Issued in NC

Practice address

1001 Blythe Blvd
Medical Center Plaza, Suite 200
Charlotte, NC 28203-5866

Phone

(704) 381-8840

Fax

(704) 381-8848

NPI assigned

Aug 12, 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 4

Medicare fee-for-service enrollment

Enrolled in MA

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

Critical Care (Intensivists)

Education

Wake Forest University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Childrens Heart Foundation IncGroup PAC ID 8729071675, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Children'S Hospital Hospital, Boston, MA, CCN 223302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmistry26338@direct.bostonchildrens.org

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.

• Boston Childrens Heart Foundation Inc

  • Pediatric Cardiology Physician
  • Boston, MA
  • NPI 1982680922

  Pediatric Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  NPD (past)

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

• Children'S Hospital Corporation

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  Care Compare affiliation

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1548272107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601372",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601372",
            "telephone_number": "704-381-8840",
            "fax_number": "704-381-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "MEDICAL CENTER PLAZA, SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840",
            "fax_number": "704-381-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "KSHITIJ",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NC",
            "license": "2004-01098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548272107",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0109C",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "136VH",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79136VH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission Post Transport Services, LLC
• Mission Post Transport Services, LLC
• Britney Leigh Misson, LCSWA
• Anna Elizabeth Mistretta, MD
• Jigneshkumar R Mistry, PHARM D
• Mitch Brothers LLC
• Jennifer Michelle Mitch, MD
• Mitchell D Hume DMD PA
• Sophia Abimbola Mitchell Mejias, PA-C
• Yasmin Mitchell-Austin

• Pediatric Critical Care Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Critical Care Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.