Active NPI
Kelly T. Mitchell, M.D.
- Ophthalmology Physician
- Lubbock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- L1942
- Practice address
- 3601 4TH St
2A100
Lubbock, TX 79430-0002 - Phone
- (806) 743-2020
- Fax
- (806) 743-1782
- NPI assigned
- Oct 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | L1942 | TX | Primary |
Addresses
Primary practice location
3601 4TH St
2A100
Lubbock, TX 79430-0002
Mailing address
PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144792205 | Medicaid | TX | |
| 144792206 | Medicaid | TX | |
| 81940 | Medicaid | NM | |
| 200013870A | Medicaid | OK | |
| 87410Z | Other | TX | HMO BLUE |
| 08534730 | Medicaid | NM | |
| 8G7982 | Other | TX | BC/BS |
| 101449101 | Medicaid | TX | |
| 81940 | Other | NM | PRESBYTERIAN COMMERCIAL |
| A582 | Other | NM | TRIWEST |
| 101449100 | Other | TX | FIRSTCARE COMMERCIAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Cincinnati College of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3601 4TH St
Lubbock, TX 79430-0002
3601 4TH St
Lubbock, TX 79430-7217
Phone (806) 743-2020
3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 743-1842
602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-1842
Hospital & facility affiliations
- University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.52 of 100
- Quality
- 87.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Current | Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current | Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Ophthalmology | Current | Accepting new patients |
| Texas Tech University Health Sciences Center Lubbock | Past | Accepting new patients |
Locations
3601 4th St
Ste 2A100
Lubbock, TX 79430
Phone (806) 743-2020
3601 4th St
#2A100
Lubbock, TX 79430
Phone (281) 455-8955
3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000
Organizations & group practices 4
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.
-
- Anatomic Pathology Physician
- Lubbock, TX
- NPI 1063461358
-
- Durable Medical Equipment & Medical Supplies
- Lubbock, TX
- NPI 1053458026
-
- Ophthalmology Physician
- Lubbock, TX
- NPI 1336198621
-
- Anesthesiology Physician
- Lubbock, TX
- NPI 1306894175
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Lubbock, TX
- NPI 1538245717
Hospital
-
- General Acute Care Hospital
- Lubbock, TX
- NPI 1821087164
-
- Hearing and Speech Clinic/Center
- Lubbock, TX
- NPI 1831299114
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388966400000",
"number": "1811988751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5865",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794085865",
"telephone_number": "806-743-2898",
"fax_number": "806-743-2787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 4TH ST",
"address_2": "2A100",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794300002",
"telephone_number": "806-743-2020",
"fax_number": "806-743-1782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "KELLY",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2014-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "L1942",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144792205",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144792206",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81940",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200013870A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO BLUE",
"identifier": "87410Z",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08534730",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8G7982",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101449101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN COMMERCIAL",
"identifier": "81940",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "A582",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE COMMERCIAL",
"identifier": "101449100",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.