Active NPI
Patient Bridge Health Medical Group, P.a.
- Emergency Medicine Physician
- Bayside, NY
National Provider Identifier
1609727536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- PATIENT BRIDGE HEALTH MEDICAL GROUP, P.A.
- Practice address
- 21212 Northern Blvd FL 3
Bayside, NY 11361-3388 - Phone
- (917) 847-0810
- NPI assigned
- Feb 6, 2026
- Last updated
- Feb 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Phillip A Mitchell
- Title
- Owner
- Phone
- (917) 847-0810
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | NU | Primary |
Addresses
Primary practice location
21212 Northern Blvd FL 3
Bayside, NY 11361-3388
Mailing address
21212 Northern Blvd FL 3
Bayside, NY 11361-3388
Phone (917) 847-0810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
21212 Northern Blvd
Fl 3
Bayside, NY 11361
Phone (917) 847-0810
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770336000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770336000000",
"number": "1609727536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21212 NORTHERN BLVD FL 3",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613388",
"telephone_number": "917-847-0810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21212 NORTHERN BLVD FL 3",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613388",
"telephone_number": "917-847-0810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PATIENT BRIDGE HEALTH MEDICAL GROUP, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2026-02-06",
"last_updated": "2026-02-06",
"certification_date": "2026-02-06",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "917-847-0810",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.