Jerrod Carl Mitzel, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD28732 Issued in OR

Practice address

2485 12TH St SE
Salem, OR 97302-2151

Phone

(503) 363-8047

Fax

(503) 363-6571

NPI assigned

Jun 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
• Providence Benedictine Home Health Home health agency, Mount Angel, OR, CCN 387074
• Salem Health West Valley Hospital, Dallas, OR, CCN 381308
• Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmitzel31363@direct.salemhealth.org

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.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD
• Salem Health

  • Family Medicine Physician
  • Woodburn, OR
  • NPI 1578112066
  NPD
• Pacific Family Medical Center LLC

  • Family Medicine Physician
  • Salem, OR
  • NPI 1902942055
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• First Call Home Health Agency, LLC

  • Home Health Agency
  • Salem, OR
  • NPI 1740260801
  Care Compare affiliation
• Providence Health & Services Oregon

  • Home Health Agency
  • Mount Angel, OR
  • NPI 1831196302
  Care Compare affiliation
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Care Compare affiliation

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1700046596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 12TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022151",
            "telephone_number": "503-363-8047",
            "fax_number": "503-363-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 12TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022151",
            "telephone_number": "503-363-8047",
            "fax_number": "503-363-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITZEL",
        "first_name": "JERROD",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-15",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57010891",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "40749",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD28732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276275",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosnitha Mitchell, DNP, PMHNP-BC
• Sabrina Mitchell
• Shannon Mitchell
• Anastasia Mitsanas
• Sviatlana Mitsina-Brown, PSYD
• Crystal Miyake, MSCCCA
• Samantha M Mize
• Zebedee Mize
• Mobility Solutions Prosthetics and Orthotics, LLC
• Modern Nose Clinic LLC

• Family Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.