NPIMap

Individual provider Active NPI

Sanjeev Kumar Mittal, MD

  • Nephrology Physician
  • Memphis, TN
National Provider Identifier
1689603102
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD32232 Issued in TN
Practice address
6027 Walnut Grove Rd Ste 402
Memphis, TN 38120-2129
Phone
(901) 767-0304
Fax
(901) 767-3884
NPI assigned
Jun 30, 2006
Last updated
Nov 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD32232 TN Primary

Addresses

Primary practice location

6027 Walnut Grove Rd Ste 402
Memphis, TN 38120-2129

Mailing address

6027 Walnut Grove Rd
402
Memphis, TN 38120-2145
Phone (901) 767-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041112001028 TN Practitioner - NephrologyPractitioner - Internal Medicine 5991768913 Reassigns benefits to 1 organization
I20050113000513 MS Practitioner - Nephrology 5991768913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mittal Kidney and Dialysis, PCGroup PAC ID 9830152958, 6 clinicians

Practice addresses (Care Compare)

300 S Walnut Bend Rd
Suite 12
Cordova, TN 38018-7527
Phone (901) 767-0101

7684 Airways Blvd
Southaven, MS 38671-5304
Phone (901) 767-0101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.16 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40
Cost
78.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD32232TNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mittal Kidney and Dialysis CurrentSince Dec 1, 2004 Accepting new patients
Mittal Kidney and Dialysis PC Nephrology CurrentSince Sep 8, 2004 Accepting new patients
Kidney Specialists, P.C. PastSince Feb 17, 2009 Accepting new patients
Memphis Neurology PLLC PastSince Aug 1, 2021 Accepting new patients
Memphis Nephrology Associates Past Accepting new patients
Kidney Care Center,P.L.L.C. Nephrology Past Accepting new patients

Locations

7318 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-2548

7620 Clarington Cv
Southaven, MS 38671
Phone (901) 767-0101

7684 Airways Blvd
Southaven, MS 38671
Phone (901) 405-0275

300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018
Phone (901) 767-0101

6027 Walnut Grove Rd
Ste 402
Memphis, TN 38120
Phone (901) 767-0101

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73850
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFDAA
  • Direct secure messaging: sanjeev.mittal@mkd.eclinicaldirectplus.com
  • Direct secure messaging: smittal33200@mlh.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1689603102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6027 WALNUT GROVE RD",
            "address_2": "402",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202145",
            "telephone_number": "901-767-0304",
            "fax_number": "901-767-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6027 WALNUT GROVE RD STE 402",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202129",
            "telephone_number": "901-767-0304",
            "fax_number": "901-767-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "SANJEEV",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "MD32232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.