Individual provider Active NPI

Henry D Mitcheson, MD

  • Urology Physician
  • Watertown, MA
National Provider Identifier
1609878065
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
48820 Issued in MA
Practice address
521 Mount Auburn St Ste 201
Watertown, MA 02472-4153
Phone
(617) 926-1200
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 48820 MA Primary

Addresses

Primary practice location

521 Mount Auburn St Ste 201
Watertown, MA 02472-4153

Mailing address

521 Mt. Auburn St., Suite 201
Watertown, MA 02472
Phone (617) 926-1200

Other identifiers 1

IdentifierTypeStateIssuer
0177938MedicaidMA

Other names 1

  • Dr. H David Mitcheson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20050725000576 MA Practitioner - Urology 9931136603 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

521 Mount Auburn St
Suite 201
Watertown, MA 02472-4153
Phone (617) 926-1200

Hospital & facility affiliations

  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48820MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward St. Elizabeth'S Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Steward St. Elizabeth'S Medical Center of Boston, Inc. CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Caritas St. Elizabeth'S Medical Center Past Accepting new patients

Locations

11 Nevins St
Ste 506
Brighton, MA 02135
Phone (617) 782-1200

11 Nevins St
Ste 501
Brighton, MA 02135
Phone (617) 782-1200

11 Nevins St
Ste 503
Brighton, MA 02135
Phone (617) 782-1200

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

77 Warren St
Fl 1
Brighton, MA 02135
Phone (617) 562-5200

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1609878065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MT. AUBURN ST., SUITE 201",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-926-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOUNT AUBURN ST STE 201",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724153",
            "telephone_number": "617-926-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHESON",
        "first_name": "HENRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "48820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177938",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H",
            "last_name": "MITCHESON",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.