Individual provider Active NPI

Spiros Mitsopoulos, MD

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1720034390
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7454 Issued in NH
Practice address
445 Cypress St
Unit 9
Manchester, NH 03103-3600
Phone
(603) 663-8230
Fax
(603) 663-8239
NPI assigned
May 25, 2006
Last updated
Sep 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7454 NH Primary

Addresses

Primary practice location

445 Cypress St
Unit 9
Manchester, NH 03103-3600

Mailing address

445 Cypress St
Unit 9
Manchester, NH 03103-3600
Phone (603) 663-8230

Other identifiers 1

IdentifierTypeStateIssuer
0102690YPNH01OtherNHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20050203000107 NH Practitioner - Internal Medicine 8022069467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

445 Cypress St
Suite 9
Manchester, NH 03103-3600
Phone (603) 683-8230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7454NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spiros Mitsopoulos, MD, PLLC Internal Medicine CurrentSince Apr 29, 2013 Accepting new patients
Elliot Professional Services Internal Medicine Past Accepting new patients
Elliot Physicians Network Internal Medicine Past Accepting new patients

Locations

445 Cypress St
Ste 9
Manchester, NH 03103
Phone (603) 663-8230

Organizations & group practices 3

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 3

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1720034390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST",
            "address_2": "UNIT 9",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-663-8230",
            "fax_number": "603-663-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST",
            "address_2": "UNIT 9",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-663-8230",
            "fax_number": "603-663-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSOPOULOS",
        "first_name": "SPIROS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "7454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0102690YPNH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.