Manisha Mittal, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M7355 Issued in ID

Practice address

413 Allumbaugh St
Ste 101
Boise, ID 83704-9212

Phone

(208) 323-1125

Fax

(208) 323-9604

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203
  NPD (past)
• Mountain States Medical Group PA

  • Family Medicine Physician
  • Boise, ID
  • NPI 1730272006
  NPD (past)
• Treasure Valley Mental Health, LLC

  • Family Psychologist
  • Boise, ID
  • NPI 1568884013
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1760534424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 ALLUMBAUGH ST",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049212",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 ALLUMBAUGH ST",
            "address_2": "STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049212",
            "telephone_number": "208-323-1125",
            "fax_number": "208-323-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "MANISHA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M7355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davida Helene Mitchell, L.AC.
• Duncan Forrest Mitchell, LCSW
• Eloise H Mitchell
• Gregory D Mitchell, M.A, L.A.T., A.T.C.
• Sam Mitchell, D.C.
• Katrina P Mittleider, PN
• Taylor L. Mitzel
• Yukiko Miura, M.D.
• Jesse William Mix, DO
• Stuart Miyasako, MD

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.