Individual provider Active NPI

Neelum Mittal, MD

  • Diagnostic Radiology Physician
  • Johnstown, PA
National Provider Identifier
1639366644
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D73848 Issued in MD
Practice address
240 Stardust Dr
Johnstown, PA 15904-3066
Phone
(814) 248-0968
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT190120 PA
Diagnostic Radiology Physician 2085R0202X D73848 MD Primary

Addresses

Primary practice location

240 Stardust Dr
Johnstown, PA 15904-3066

Mailing address

240 Stardust Dr
Johnstown, PA 15904-3066
Phone (814) 248-0968

Other identifiers 1

IdentifierTypeStateIssuer
054872300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120612000301 MD Practitioner - Diagnostic Radiology 9739343351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Hahnemann University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

1734 York Rd
Lutherville, MD 21093-5606
Phone (410) 252-2273

301 Saint Paul St
Baltimore, MD 21202-2102

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

7927 Ritchie Hwy
Glen Burnie, MD 21061-4345
Phone (410) 761-2273

Hospital & facility affiliations

  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008
  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009
  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044
  • Medstar Good Samaritan Hospital Hospital, Baltimore, MD, CCN 210056

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT190120PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists Inc Diagnostic Radiology CurrentSince Nov 1, 2015 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

Organizations & group practices 2

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 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": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1639366644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 STARDUST DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043066",
            "telephone_number": "814-248-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 STARDUST DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043066",
            "telephone_number": "814-248-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "NEELUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT190120",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D73848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054872300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.