Active NPI
Brian Adam Mitzman, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Mineola, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 11792013-1205
- Practice address
- 259 1St St
Mineola, NY 11501 - Phone
- (516) 663-0333
- NPI assigned
- Apr 23, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 036137118 | IL | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 292999 | NY | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 11792013-1205 | UT | Primary |
Addresses
Primary practice location
259 1St St
Mineola, NY 11501
Mailing address
259 1St St
Mineola, NY 11501-3957
Other practice location 1
5841 S Maryland Ave
MC 5040
Chicago, IL 60637-1447
Phone (773) 702-2500
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bmitzman444177@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995
Hospital & facility affiliations
- University of Utah Hospital and Clinics
- St Johns Medical Center
- Memorial Hospital Sweetwater County
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair (minimally invasive) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11792013-1205 | UT | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients |
Locations
250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- bmitzman444177@direct.med.utah.edu
Organizations & group practices 3
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.
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- Physical Therapist
- Salt Lake City, UT
- NPI 1487000287
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Rock Springs, WY
- NPI 1558361949
-
- General Acute Care Hospital
- Jackson, WY
- NPI 1801835475
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1487734976
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1598082000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 1ST ST",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 1ST ST",
"city": "MINEOLA",
"state": "NY",
"postal_code": "11501",
"telephone_number": "516-663-0333"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave",
"address_2": "MC 5040",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371447",
"country_code": "US",
"telephone_number": "773-702-2500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITZMAN",
"first_name": "BRIAN",
"middle_name": "ADAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-23",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "IL",
"license": "036137118",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "NY",
"license": "292999",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "UT",
"license": "11792013-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bmitzman444177@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.