NPIMap

Individual provider Active NPI

Jared D Mitchell, MD

  • Family Medicine Physician
  • Eldorado, IL
National Provider Identifier
1760864987
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.163741 Issued in IL
Practice address
1306 Maple St
Eldorado, IL 62930-1662
Phone
(618) 297-9665
Fax
(618) 297-9638
NPI assigned
Jun 24, 2015
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11018503A IN
Family Medicine Physician 207Q00000X 01077168A IN
Family Medicine Physician 207Q00000X 036.163741 IL Primary

Addresses

Primary practice location

1306 Maple St
Eldorado, IL 62930-1662

Mailing address

1201 Pine St
Eldorado, IL 62930-1634

Other practice location 1

8077 Rose Hill Dr
Newburgh, IN 47630-2811
Phone (812) 853-7363

Other practice location 2

14020 Old State Rd Ste 100
Evansville, IN 47725-1121
Phone (812) 469-4765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010000896 IL Practitioner - Family Practice 0042522302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pine St
Eldorado, IL 62930-1634
Phone 61827333611660

1306 Maple St
Eldorado, IL 62930-1662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.163741ILMDFamily Medicine Physician
11018503AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ferrell Hospital Community Foundation Family Medicine CurrentSince Aug 27, 2023 Accepting new patients
Ferrell Hospital Community Foundation Current Accepting new patients
Ferrell Hospital Community Foundation CurrentSince Aug 27, 2023 Accepting new patients
St. Mary's Health, Inc Family Medicine Past Accepting new patients

Locations

1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361

1306 Maple St
Eldorado, IL 62930
Phone (618) 273-2360

Interoperability endpoints

  • Direct secure messaging: jmitchell74332@direct.deaconess.com

Organizations & group practices 4

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1760864987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MAPLE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301662",
            "telephone_number": "618-297-9665",
            "fax_number": "618-297-9638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8077 Rose Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476302811",
            "country_code": "US",
            "telephone_number": "812-853-7363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14020 Old State Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477251121",
            "country_code": "US",
            "telephone_number": "812-469-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JARED",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11018503A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01077168A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.163741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.