Organization Active NPI

Patient Bridge Health Medical Group, P.a.

  • Emergency Medicine Physician
  • Bayside, NY
National Provider Identifier
1609727536
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Authorized official

Name
Dr. Phillip A MitchellNPI 1518932102
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)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
O20260610002155 NY Part B Supplier - Clinic/Group Practice 5294206280 Receives reassigned benefits from 1 practitioner
Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.