NPIMap

Individual provider Active NPI

Mithun Kotresh Neral, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Clarkston, MI
National Provider Identifier
1699195990
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
MD61071240 Issued in WA
Practice address
6815 Dixie Hwy Ste 1
Clarkston, MI 48346-2092
Phone
(248) 384-8350
Fax
(248) 384-8351
NPI assigned
Apr 24, 2014
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD61071240 WA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD61071240 WA Primary

Addresses

Primary practice location

6815 Dixie Hwy Ste 1
Clarkston, MI 48346-2092

Mailing address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215002239 MI Practitioner - Orthopedic Surgery 0345543005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Pittsburgh School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6815 Dixie Hwy
Suite 1
Clarkston, MI 48346-2092
Phone (248) 384-8350

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Feb 1, 2023 Accepting new patients
McLaren Community Based Primary Care Group Orthopaedic Surgery CurrentSince Jan 5, 2026 Accepting new patients
McLaren Community Based Primary Care Group CurrentSince Jan 5, 2026 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Feb 1, 2023 Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 100
Clarkston, MI 48346
Phone (248) 625-2621

6815 Dixie Hwy
Ste 1
Clarkston, MI 48346
Phone (248) 384-8350

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

Interoperability endpoints

  • Direct secure messaging: mithun.neral.1@3928.direct.athenahealth.com
  • Direct secure messaging: mneral2706494@direct.trinity-health.org

Organizations & group practices 4

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 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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1699195990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 DIXIE HWY STE 1",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462092",
            "telephone_number": "248-384-8350",
            "fax_number": "248-384-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERAL",
        "first_name": "MITHUN",
        "middle_name": "KOTRESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61071240",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WA",
            "license": "MD61071240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.