Amitabha Mitra, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036114006 Issued in IL

Practice address

121 S Wilke Rd Ste 111
Arlington Heights, IL 60005-1524

Phone

(847) 394-1843

NPI assigned

Jan 16, 2006

Last updated

Nov 22, 2024By 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 1

Addresses

Other identifiers 1

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

NephrologyAlso: Internal Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associates in Nephrology SCGroup PAC ID 9133023963, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC - Rolling Meadows Dialysis facility, Rolling Meadows, IL, CCN 142525
• FMC - Mount Prospect Dialysis facility, Mount Prospect, IL, CCN 142843
• DaVita Arlington Heights Renal Center Dialysis facility, Arlington Heights, IL, CCN 142628
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amitra18521@direct.acumenmd.com

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.

• Associates in Nephrology, S.C.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1184694259
  Medicare reassignment Care Compare group NPD Authorized official
• Vascular Access Centers of Illinois at Morgan Park, LLC

  • Ambulatory Surgical Clinic/Center
  • Chicago, IL
  • NPI 1689163875
  NPD Authorized official
• Northwest Kidney Kare PC

  • Nephrology Physician
  • Arlington Heights, IL
  • NPI 1386681195
  NPD

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

• Fresenius Medical Care Chicagoland, LLC

  dba Fresenius Medical Care Rolling Meadows

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rolling Meadows, IL
  • NPI 1477986743

  Dialysis facility

  Care Compare affiliation Name & address match
• Fresenius Medical Care Mount Prospect, LLC

  dba Fresenius Kidney Care Mount Prospect

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Prospect, IL
  • NPI 1801301866

  Dialysis facility

  Care Compare affiliation Name & address match
• Isd Renal Inc

  dba Arlington Heights Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Arlington Heights, IL
  • NPI 1003832148

  Dialysis facility

  Care Compare affiliation Name & address match
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1811976954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2700",
            "fax_number": "312-654-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD STE 111",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051524",
            "telephone_number": "847-394-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "AMITABHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036114006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Minton, SLP
• Jasmine Mirabelli, APN-CRNA
• Sumbal Mirza
• Bethany Jane Mitchell, M.A.
• Daniel Mitchell, M.D.
• Cristina M Mix, OT
• Nicole Elizabeth Mize, APN-CRNA
• Numairuddin Mohammed, DO
• Omar I Mohammed, MD
• Tahseen Mohammed, M.D.

• Nephrology Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.