Daniella Mariana Mittan, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

P1901 Issued in TX

Practice address

1605 Rock Prairie Rd
Suite 301
College Station, TX 77845-8358

Phone

(979) 764-0107

Fax

(979) 764-0173

NPI assigned

Aug 14, 2006

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Endocrinology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
• Baylor Scott & White Hospital Brenham Hospital, Brenham, TX, CCN 451397
• Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088
• Madison St Joseph Health Center Hospital, Madisonville, TX, CCN 451316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Madison St Joseph Health Center

  dba CHI St Joseph Health Madison Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Madisonville, TX
  • NPI 1033272398
  Care Compare affiliation
• Madison St Joseph Health Center

  dba CHI St Joseph Health Madison Hospital

  • Critical Access Hospital
  • Madisonville, TX
  • NPI 1780731737
  Care Compare affiliation
• Scott & White Hospital - College Station

  dba Baylor Scott & White Medical Center - College Station

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1265772362
  Care Compare affiliation
• Scott & White Hospital Brenham

  dba Baylor Scott & White Medical Center - Brenham

  • Critical Access Hospital
  • Brenham, TX
  • NPI 1154315307
  Care Compare affiliation
• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  dba CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1598778102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 ROCK PRAIRIE RD",
            "address_2": "SUITE 301",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458358",
            "telephone_number": "979-764-0107",
            "fax_number": "979-764-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROCK PRAIRIE RD",
            "address_2": "SUITE 301",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458358",
            "telephone_number": "979-764-0107",
            "fax_number": "979-764-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAN",
        "first_name": "DANIELLA",
        "middle_name": "MARIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "MD23561",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "P1901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287026",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Steven Minor, M.D.
• Monika Mishra, M.D.
• Mitchell Enterprises Staffing Agency
• Gloria Ivana Mitchell, RD
• Lakita H Mitchell
• Roxane G Mlcak, DDS
• Mmci, Inc
• Mobile Docs PLLC
• Chad E Moffitt, O.D.
• Onyedika Moghalu, M.D.

• Endocrinology, Diabetes & Metabolism Physician in College Station, TX
• Providers in College Station, TX by specialty
• Endocrinology, Diabetes & Metabolism Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.