Rei Mitsuyama, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD19179 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-4741

NPI assigned

May 18, 2020

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rmitsuyama242337@direct.bmc.masshiway.net

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.

• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1811519408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELM ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4741",
            "fax_number": "401-444-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITSUYAMA",
        "first_name": "REI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP04836",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD19179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Mitchell, LICSW
• Patricia Antonia Mitchell, MS
• Natasha Mitchner-Soares, LCSW
• John Arthur Mitchner, LCDP
• Kendra Mitchner
• Srilakshmi Mitta, M.D.
• Amol Mittal, M.D.
• Margaret Mittner, LICSW
• Danielle F Miyagishima, M.D., PH.D.
• Areum Mo, RPH

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.