NPIMap

Individual provider Active NPI

Benjamin Jacob Mitchell, MD

  • Emergency Medicine Physician
  • Hurlburt Field, FL
National Provider Identifier
1558379073
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD26619 Issued in OR
Practice address
113 Lielmanis Ave
1 Somdg
Hurlburt Field, FL 32544
Phone
(850) 881-2337
Fax
(850) 881-2323
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD26619 OR Primary

Addresses

Primary practice location

113 Lielmanis Ave
1 Somdg
Hurlburt Field, FL 32544

Mailing address

113 Lielmanis Ave
1 Somdg
Hurlburt Field, FL 32544
Phone (850) 881-2337

Other identifiers 1

IdentifierTypeStateIssuer
O05961MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230211000564 CO Practitioner - Emergency Medicine 8123020823 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Cincinnati College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1024 S Lemay Ave
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 495-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.35
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
91.15
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs of Colorado Inc Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Usacs of Colorado, Inc Emergency Medicine Current Accepting new patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Usacs of Colorado Inc Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Southern Oregon Emergency Care LLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Franklin County, LTD Emergency Medicine Past Accepting new patients
Sky Lakes Medical Center Inc Past Accepting new patients

Locations

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

Organizations & group practices 10

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1558379073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "address_2": "1 SOMDG",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-881-2337",
            "fax_number": "850-881-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "address_2": "1 SOMDG",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-881-2337",
            "fax_number": "850-881-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BENJAMIN",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD26619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O05961",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurlburt Field, FL

Sources for this page

Verify at the official NPI Registry.