Michael Charles Mistretta, D.D.S., M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

240428-1 Issued in NY

Practice address

200 Central Park S
Suite 105
New York, NY 10019-1436

Phone

(212) 245-3292

Fax

(212) 245-8758

NPI assigned

Jul 17, 2006

Last updated

Apr 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 30, 2014 through May 30, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mmistretta51492@northwell.direct-ci.com

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1780602920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CENTRAL PARK S",
            "address_2": "SUITE 105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191436",
            "telephone_number": "212-245-3292",
            "fax_number": "212-245-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CENTRAL PARK S",
            "address_2": "SUITE 105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191436",
            "telephone_number": "212-245-3292",
            "fax_number": "212-245-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "049087-1",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "240428-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Care Homecare LLC
• Deborah Missud, LMHC
• Natalie Mistikawy, DO
• Andie Mistler, MHC-LP
• Lauren Mistretta, MA
• Gaia E Mistriel
• Anushka Mistry, OD
• Disha Narendra Mistry
• Nidhikumari Harishbhai Mistry
• Julianna Misuraca, LCSW

• Oral & Maxillofacial Surgery (D.M.D.) in New York, NY
• Providers in New York, NY by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.