Individual provider Active NPI

Jeannette Mighty, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1801011374
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT186910 Issued in PA
Practice address
2501 W Lehigh Ave
Philadelphia, PA 19132-3207
Phone
(215) 227-0300
Fax
(215) 227-0302
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT186910 PA Primary

Addresses

Primary practice location

2501 W Lehigh Ave
Philadelphia, PA 19132-3207

Mailing address

8309 High School Rd
Elkins Park, PA 19027-2009
Phone (717) 379-9841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20140806000453 PA Practitioner - Pediatric Medicine 0244457802 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT186910PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jun 14, 2014 Accepting new patients
City of Philadelphia CurrentSince Jun 14, 2014 Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

1101 Market St
Fl 10
Philadelphia, PA 19107

2230 Cottman Ave
Philadelphia, PA 19149
Phone (215) 685-0603

Interoperability endpoints

  • Direct secure messaging: jeannette.mighty@pdphahs.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1801011374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 HIGH SCHOOL RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272009",
            "telephone_number": "717-379-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191323207",
            "telephone_number": "215-227-0300",
            "fax_number": "215-227-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGHTY",
        "first_name": "JEANNETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT186910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.