Active NPI
Mitchell K Rauch, M.D.
- Urology Physician
- Boca Raton, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME0068700
- Practice address
- 670 Glades Road
Suite 200
Boca Raton, FL 33431 - Phone
- (561) 391-6470
- Fax
- (561) 394-2306
- NPI assigned
- Jul 24, 2006
- Last updated
- May 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME0068700 | FL | Primary |
Addresses
Primary practice location
670 Glades Road
Suite 200
Boca Raton, FL 33431
Mailing address
150 Clinic Ave
Ste 202
Carrollton, GA 30117-4402
Phone (678) 390-7164
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 253485100 | Medicaid | FL | |
| 42722 | Other | FL | BCBS |
| 1453279 | Other | FL | CIGNA |
| 259384 | Other | FL | AVMED |
| P01606320 | Other | FL | RR MEDICARE |
| 0E640 | Other | FL | WELLCARE |
| P1035782 | Other | FL | FREEDOM |
| P971547 | Other | FL | OPTIMUM |
| 4386 | Other | FL | DIMENSION HEALTH |
| 5682670 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Albany Medical College of Union University, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
150 Clinic Ave
Suite 202
Carrollton, GA 30117-4402
Phone (770) 834-6988
Hospital & facility affiliations
- Tanner Medical Center - Carrollton
- Tanner Medical Center Villa Rica
- Tanner Medical Center-East Alabama
- Higgins General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0068700 | FL | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanner Medical Group Inc | Current | Accepting new patients | |
| West Georgia Urology Associates PC | Urology | Current | Accepting new patients |
| Genesiscare USA of Florida LLC | Urology | Past | Accepting new patients |
Locations
150 Clinic Ave
Ste 202
Carrollton, GA 30117
Phone (770) 834-6968
150 Clinic Ave
Ste 203
Carrollton, GA 30117
Phone (770) 834-0613
706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825
690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646
705 Dallas Hwy
Ste 205
Villa Rica, GA 30180
Phone (770) 771-5235
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Carrollton, GA
- NPI 1396979787
-
- Urology Physician
- Carrollton, GA
- NPI 1982701124
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Tanner Medical Center East Alabama
- Critical Access Hospital
- Wedowee, AL
- NPI 1912428301
-
dba Tanner Health System
- General Acute Care Hospital
- Carrollton, GA
- NPI 1801883780
-
dba Tanner Health System
- Critical Access Hospital
- Bremen, GA
- NPI 1194712083
-
dba Tanner Health System
- General Acute Care Hospital
- Villa Rica, GA
- NPI 1851388748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525651200000",
"number": "1639191190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 CLINIC AVE",
"address_2": "STE 202",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174402",
"telephone_number": "678-390-7164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 GLADES ROAD",
"address_2": "SUITE 200",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33431",
"telephone_number": "561-391-6470",
"fax_number": "561-394-2306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUCH",
"first_name": "MITCHELL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2018-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME0068700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "253485100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "42722",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1453279",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "259384",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01606320",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "0E640",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FREEDOM",
"identifier": "P1035782",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM",
"identifier": "P971547",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIMENSION HEALTH",
"identifier": "4386",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5682670",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.