Todd Ryan Mitchell, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.131197 Issued in IL

Practice address

530 NE Glen Oak Ave
Emergency Medicine
Peoria, IL 61603-3133

Phone

(309) 655-6710

NPI assigned

Aug 7, 2009

Sex

Male

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

Enrolled in IL

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

Specialty

Emergency Medicine

Education

Pennsylvania State University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289

Merit-based Incentive Payment System (MIPS)

Final score

81.29 of 100Reported as individual

Quality

93.8

Improvement activities

0

Cost

79.98

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.

• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment Care Compare group NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment NPD

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1770714776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 113",
            "city": "DEER CREEK",
            "state": "IL",
            "postal_code": "617330113",
            "telephone_number": "309-447-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033133",
            "telephone_number": "309-655-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TODD",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.131197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig S Mitchell, DO
• Daniel S Mitchell, MD
• Jessica M Mitchell, APRN, CNP
• Molli Mitchell
• Stephanie Mitchell, RBT
• Andrea Jo Mitts
• Donald E Mitzelfelt, MD
• MJM Family Medicine SC
• William Ted Mlotek, DC
• Muhammad Talha Moazzam, MD

• Emergency Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.