NPIMap

Individual provider Active NPI

Vikas Simon Mittal, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1629038377
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42701 Issued in MN
Practice address
1675 Village TRL E Unit 6
Saint Paul, MN 55109-5820
Phone
(507) 363-9367
NPI assigned
Mar 26, 2006
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42701 MN Primary

Addresses

Primary practice location

1675 Village TRL E Unit 6
Saint Paul, MN 55109-5820

Mailing address

1675 Village TRL E
Unit # 6
Maplewood, MN 55109-5819
Phone (507) 363-9367

Other identifiers 1

IdentifierTypeStateIssuer
764422100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060104000359 MN Practitioner - Internal Medicine 2961425079 Reassigns benefits to 6 organizations
I20231016002381 WI Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 2961425079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1265 Grey Fox Rd
Suite 100
Arden Hills, MN 55112-6904
Phone (952) 607-6894

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.69 of 100Reported as group
Quality
91.97
Improvement activities
40
Cost
69.67

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
A&E Health LLC Internal Medicine CurrentSince Aug 9, 2025 Accepting new patients
Selah Wellness Clinic LLC CurrentSince Dec 1, 2024 Accepting new patients
Global Telemedicine, LLC Current Accepting new patients
Infinite Medical PC CurrentSince Jan 15, 2024 Accepting new patients
LTC Professionals, PLLC Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
St. Croix Valley Shared Services, Inc. CurrentSince Jul 8, 2023 Accepting new patients
Selah Wellness Clinic LLC CurrentSince Dec 1, 2024 Accepting new patients
St. Croix Valley Shared Services, Inc. CurrentSince Jul 8, 2023 Accepting new patients
Life Rejuvenated USA, LLC Current Accepting new patients
True Grace Clinic LTD CurrentSince Aug 1, 2025 Accepting new patients
Renville Olivia Holdings LLC Past Accepting new patients
Selah Wellness Clinic LLC PastSince Aug 1, 2025 Accepting new patients
Redwood Wabasso Holdings LLC Past Accepting new patients
Renville Franklin Holdings LLC Past Accepting new patients
Lake Valley Hospice LLC PastSince Apr 1, 2024 Accepting new patients

Locations

7801 E Bush Lake Rd
Ste 400
Minneapolis, MN 55439
Phone (952) 283-3162

1300 Northridge Ct NW
Pine City, MN 55063
Phone (320) 372-2312

1300 Northridge Ct NW
Ste 2
Pine City, MN 55063
Phone (320) 372-2312

3131 France Ave N
Robbinsdale, MN 55422
Phone (763) 588-0771

3245 Vera Cruz Ave N
Robbinsdale, MN 55422
Phone (516) 729-0070

1265 Grey Fox Rd
Saint Paul, MN 55112
Phone (800) 826-9703

1265 Grey Fox Rd
Ste 100
Saint Paul, MN 55112
Phone (952) 607-6894

250 Skillman St
Ste 202
Brooklyn, NY 11205

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26347/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Augustana Chapel View Homes IncHopkins, MN, CCN 245493 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2025
Oct 1, 2025
Good Samaritan Society - Inver Grove HeightsInver Grove Heights, MN, CCN 245285 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2019
Feb 1, 2019
Good Samaritan Society - ComforcareAustin, MN, CCN 245317 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2022
May 1, 2022
St. Anthony Health & RehabilitationMinneapolis, MN, CCN 245267 Skilled nursing facility Contracted Managing Employee Nov 3, 2023
Three Links Care CenterNorthfield, MN, CCN 245450 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Saint Therese of Oxbow Lake, LLCBrooklyn Park, MN, CCN 245619 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2020
Jul 1, 2025
Adoray Home Health and HospiceBaldwin, WI, CCN 521521 Hospice Contracted Managing Employee Aug 31, 2021
Lake Valley Hospice LLCSaint Louis Park, MN, CCN 241619 Hospice Contracted Managing Employee Apr 1, 2024

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 4

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": "1143331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1629038377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 VILLAGE TRL E",
            "address_2": "UNIT # 6",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095819",
            "telephone_number": "507-363-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 VILLAGE TRL E UNIT 6",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551095820",
            "telephone_number": "507-363-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "VIKAS",
        "middle_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-26",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "42701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764422100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.