Individual provider Active NPI

Bennett Mitchell, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1639140205
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7323 Issued in NV
Practice address
540 N Nellis Blvd
Las Vegas, NV 89110-5368
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7323 NV Primary

Addresses

Primary practice location

540 N Nellis Blvd
Las Vegas, NV 89110-5368

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other practice location 1

2225 Civic Center Dr
North Las Vegas, NV 89030-6338
Phone (702) 877-5319

Other identifiers 2

IdentifierTypeStateIssuer
1639140205MedicaidNV
2019532MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20110513000635 NV Practitioner - Family Practice 9436063872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone (702) 579-3253

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Jan 1, 1976 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 1, 2019 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Linda L. Johnson MD, LTD Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Southwest Medical Associates Inc. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

300 E Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 435-4301

540 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-7424

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

2225 Civic Center Dr
North Las Vegas, NV 89030
Phone (702) 732-2020

Interoperability endpoints

  • Direct secure messaging: bmitchell119208@westdirect.optum.com

Organizations & group practices 9

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1639140205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199",
            "fax_number": "702-259-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 Civic Center Dr",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890306338",
            "country_code": "US",
            "telephone_number": "702-877-5319",
            "fax_number": "702-259-0128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BENNETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "7323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639140205",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019532",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.