Jimmy Mistry, M. D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

4301031744 Issued in MI

Practice address

93 W Fourth St Ste B
Suttons Bay, MI 49682-8408

Phone

(231) 271-2002

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Suttons Bay Medical Clinic, PLC

  • Clinic/Center
  • Suttons Bay, MI
  • NPI 1497868111
  NPD

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1730208810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 W FOURTH ST STE B",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496828408",
            "telephone_number": "231-271-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W FOURTH ST STE B",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496828408",
            "telephone_number": "231-271-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "JIMMY",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301031744",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4301031744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036581",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark a Priest DO PC
• Michelle Martines
• Justin Mazurek
• Thor L Mikesell, DDS
• Donald R Mileski, RPH
• John Allen Nagel, RPH
• Amber G Noble, P.T.
• Theresa O'Boyle, CHW
• Kimberly Sue Oldenburg, NP
• Jessica M Paquette, DO

• Gynecology Physician in Suttons Bay, MI
• Providers in Suttons Bay, MI by specialty
• Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.