Mitas LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

MITAS LLC

Practice address

1191 Fortune Blvd Ste 2
Shiloh, IL 62269-7474

Phone

(404) 580-8511

NPI assigned

Dec 21, 2020

Organization subpart

No

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

Authorized official

Name

Swastik Sinha, M.D.NPI 1013163120

Title

Owner

Phone

(618) 713-5211

Specialties & licenses 2

Addresses

Other names 1

• Axis Spine and Orthopedics Doing business as

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Enrollment records 2

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Swastik Kumar Sinha, M.D.

  • Orthopaedic Surgery Physician
  • Shiloh, IL
  • NPI 1013163120

  MO, Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Polly Bhattacharyya Sinha, P.T.

  • Physical Therapist
  • Shiloh, IL
  • NPI 1730215054
  Medicare reassignment Care Compare group NPD
• Kelli Richardson, DPT

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1871806398

  IL

  Medicare reassignment NPD
• Nicole Renee Brunaugh, NP

  • Gerontology Nurse Practitioner
  • Alton, IL
  • NPI 1750958351
  Medicare reassignment
• Jennifer Jeanne Jouett, PA-C

  • Physician Assistant
  • Shiloh, IL
  • NPI 1114259199
  NPD
• Jamie L McGinness, M.D.

  • MOHS-Micrographic Surgery Physician
  • Springfield, IL
  • NPI 1447291356
  NPD
• Kyla Gelina Sulcer, PTA

  • Physical Therapy Assistant
  • Shiloh, IL
  • NPI 1558068171
  NPD
• Diana Leigh Vork

  • Dermatology Physician
  • Shiloh, IL
  • NPI 1871028316
  NPD
• Jacquelyn McGinness

  • Nurse Practitioner
  • Minneapolis, MN
  • NPI 1699856393
  NPD

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1659967917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 FORTUNE BLVD STE 2",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697474",
            "telephone_number": "404-580-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 FORTUNE BLVD STE 2",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697474",
            "telephone_number": "404-580-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2025-09-02",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SINHA",
        "authorized_official_first_name": "SWASTIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-713-5211",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Spine and Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley N Mehochko, MSN, APRN, FNP-BC
• Arkady Melikyan, MD
• Mercy Pharmacy Services LLC
• Metro East Dermatology & Skin Cancer Center LLC
• Metro-East Services, Inc.
• David L Mitchell, M.D.
• Tracy Rene Moore, LPN,CSFA
• Daniel Rocco Morra, MD
• Sarah Anne Mossa
• Msa Alliance, LLC

• Orthopaedic Surgery Physician in Shiloh, IL
• Providers in Shiloh, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.