Individual provider Active NPI

Karen C. Mitchell, M.D.

  • Dermatopathology Physician
  • Marlborough, MA
National Provider Identifier
1619986114
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
208889 Issued in MA
Practice address
340 Maple St
Suite 203
Marlborough, MA 01752-3200
Phone
(508) 485-7779
Fax
(508) 485-7769
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 208889 MA Primary

Addresses

Primary practice location

340 Maple St
Suite 203
Marlborough, MA 01752-3200

Mailing address

340 Maple St
Suite 203
Marlborough, MA 01752-3200
Phone (508) 485-7779

Other identifiers 1

IdentifierTypeStateIssuer
110062526AMedicaidMA

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
I20060828000364 MA Practitioner - Dermatology 0547264913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louis Kuchnir MD PCGroup PAC ID 0143270868, 17 clinicians

Practice addresses (Care Compare)

11 Apex Dr
Suite 103a
Marlborough, MA 01752-1860
Phone 5084857779857779

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions332
Skin biopsy54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208889MAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louis Kuchnir MD PC CurrentSince Jan 1, 2015 Accepting new patients

Locations

340 Maple St
Ste 203
Marlborough, MA 01752
Phone (508) 485-7779

11 Apex Dr
Ste 103A
Marlborough, MA 01752
Phone (508) 485-7779

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1619986114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "address_2": "SUITE 203",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-7779",
            "fax_number": "508-485-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "address_2": "SUITE 203",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-7779",
            "fax_number": "508-485-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KAREN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MA",
            "license": "208889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110062526A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.