Active NPI
Jacques Mistrot, M.D.
- Specialist
- Raleigh, NC
National Provider Identifier
1679801146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 26687
- Practice address
- 3008 Randolph Dr
Raleigh, NC 27609-6942 - Phone
- (919) 782-7365
- NPI assigned
- Nov 22, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 26687 | NC | Primary |
Addresses
Primary practice location
3008 Randolph Dr
Raleigh, NC 27609-6942
Mailing address
3008 Randolph Dr
Raleigh, NC 27609-6942
Phone (919) 782-7365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26687 | Other | NC | STATE OF NC MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26687 | NC | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Cardiovascular Surgical Associates P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1104809730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258848000000",
"number": "1679801146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 RANDOLPH DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096942",
"telephone_number": "919-782-7365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3008 RANDOLPH DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096942",
"telephone_number": "919-782-7365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTROT",
"first_name": "JACQUES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-22",
"last_updated": "2009-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "26687",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NC MEDICAL LICENSE",
"identifier": "26687",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.