Individual provider Active NPI

Jay Patrick Mitchell, M.D.

  • Specialist
  • Rochester Hills, MI
National Provider Identifier
1689651259
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301051931 Issued in MI
Practice address
2370 Walton Blvd
Suite 3
Rochester Hills, MI 48309-1471
Phone
(248) 651-8197
Fax
(248) 651-5643
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301051931 MI Primary

Addresses

Primary practice location

2370 Walton Blvd
Suite 3
Rochester Hills, MI 48309-1471

Mailing address

4467 Ascot CT
Oakland Township, MI 48306-4719
Phone (248) 340-6166

Other identifiers 1

IdentifierTypeStateIssuer
4286748MedicaidMI

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

LicenseStateTypeSpecialty
4301051931MIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz 1St, P.L.L.C. Specialist PastSince Oct 2, 2022 Accepting new patients
Triad Medicine and Pediatric Associates, PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689651259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 ASCOT CT",
            "city": "OAKLAND TOWNSHIP",
            "state": "MI",
            "postal_code": "483064719",
            "telephone_number": "248-340-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 WALTON BLVD",
            "address_2": "SUITE 3",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091471",
            "telephone_number": "248-651-8197",
            "fax_number": "248-651-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JAY",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301051931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4286748",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.