Individual provider Active NPI

Matthew D Mitchell, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1710113550
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN573737 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(215) 829-3867
Fax
(215) 829-5567
NPI assigned
Jun 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NJ00363700 NJ
Certified Registered Nurse Anesthetist 367500000X RN573737 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

1945 Rte 33
Neptune, NJ 07753
Phone (732) 776-4945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090625000538 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921159278 Reassigns benefits to 1 organization
I20120530000206 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921159278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Society Hill Anesthesia Consultants PCGroup PAC ID 5991617292, 210 clinicians

Practice addresses (Care Compare)

1945 Route 33
Ackerman 4
Neptune, NJ 07753
Phone (732) 776-4949

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-5664

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00363700NJMDCertified Registered Nurse Anesthetist
RN573737PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 31, 2024 Accepting new patients
Jersey Shore Anesthesiology Associates PA CurrentSince May 15, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 31, 2024 Accepting new patients
Society Hill Anesthesia Consultants, PC CurrentSince Jun 15, 2009 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Past Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 State Route 33
#4
Neptune, NJ 07753
Phone (732) 776-4949

1945 Corlies Ave
Neptune City, NJ 07753
Phone (732) 776-4203

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1710113550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3867",
            "fax_number": "215-829-5567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 Rte 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "07753",
            "country_code": "US",
            "telephone_number": "732-776-4945",
            "fax_number": "732-776-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2024-08-05",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00363700",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN573737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.