Individual provider Active NPI

Mira Saad Mitry, M.D.

  • Hospitalist Physician
  • Detroit, MI
National Provider Identifier
1730441031
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
4301106835 Issued in MI
Practice address
4201 Saint Antoine St
Suite 5C
Detroit, MI 48201-2153
Phone
(313) 745-7999
Fax
(313) 966-6400
NPI assigned
Jun 12, 2012
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301106835 MI
Internal Medicine Physician 207R00000X 333329 LA
Hospitalist Physician 208M00000X 333329 LA
Hospitalist Physician 208M00000X 4301106835 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Suite 5C
Detroit, MI 48201-2153

Mailing address

1000 Houghton Ave
Saginaw, MI 48602-5303
Phone (989) 746-7952

Other practice location 1

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150622001758 MI Practitioner - Internal MedicinePractitioner - Hospitalist 4981841764 Reassigns benefits to 4 organizations
I20221221001551 LA Practitioner - Internal Medicine 4981841764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-4108

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333329LAMDHospitalist Physician
4301106835MIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Internal Medicine CurrentSince Nov 17, 2022 Accepting new patients
Belle Chasse Physician Services LLC Hospitalist CurrentSince Jan 9, 2024 Accepting new patients
Iha Health Services Corporation Hospitalist CurrentSince Dec 1, 2021 Accepting new patients
Michigan Emergency Services CurrentSince Oct 1, 2016 Accepting new patients
University Physician Group CurrentSince Jun 24, 2015 Accepting new patients
Saginaw Cooperative Hospitals, Inc Internal Medicine Current Accepting new patients
Ochsner Clinic LLC Internal Medicine CurrentSince Nov 17, 2022 Accepting new patients
University Physician Group Internal Medicine CurrentSince Jun 24, 2015 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Saginaw Cooperative Hospital Inc Internal Medicine CurrentSince Jun 24, 2024 Accepting new patients
Iha Health Service Corporation CurrentSince Dec 1, 2021 Accepting new patients

Locations

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

100 Medical Center Dr
Slidell, LA 70461
Phone (504) 392-3131

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

4201 Saint Antoine St
Ste 3R
Detroit, MI 48201
Phone (313) 745-3330

4201 Saint Antoine St
Ste 5C
Detroit, MI 48201
Phone (313) 577-5030

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

1000 Houghton Ave
Saginaw, MI 48602
Phone (989) 583-6800

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: mmitry@direct.dmc.org
  • Direct secure messaging: mmitry1576439@direct.trinity-health.org

Organizations & group practices 12

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1730441031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303",
            "telephone_number": "989-746-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 5C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-7999",
            "fax_number": "313-966-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-7511",
            "fax_number": "504-842-2644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITRY",
        "first_name": "MIRA",
        "middle_name": "SAAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301106835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "333329",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "333329",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301106835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.