NPIMap

Individual provider Active NPI

Michael J Mitchko, M.D.

  • Internal Medicine Physician
  • Canandaigua, NY
National Provider Identifier
1811990898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209841 Issued in NY
Practice address
335 Parrish St
Canandaigua, NY 14424-1728
Phone
(585) 393-2862
Fax
(585) 396-9275
NPI assigned
May 24, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 209841 NY Primary

Addresses

Primary practice location

335 Parrish St
Canandaigua, NY 14424-1728

Mailing address

335 Parrish St
Canandaigua, NY 14424-1728
Phone (585) 393-2862

Other identifiers 2

IdentifierTypeStateIssuer
02068766MedicaidNY
MDF311OtherNYPREFERRED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803000187 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2264485390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560

335 Parrish St
Canandaigua, NY 14424-1728
Phone (585) 393-2888

350 Parrish St
Canandaigua, NY 14424-1731
Phone (585) 396-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Jan 1, 2002 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Jan 1, 2002 Accepting new patients
Hospitalist Medicine Physicians of New York, PLLC Past Accepting new patients

Locations

335 Parrish St
Canandaigua, NY 14424
Phone (585) 393-2888

350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000

73 Buffalo St
Ste 100
Canandaigua, NY 14424

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

Interoperability endpoints

  • Direct secure messaging: mmitchko82800@direct.urmc.rochester.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811990898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241728",
            "telephone_number": "585-393-2862",
            "fax_number": "585-396-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241728",
            "telephone_number": "585-393-2862",
            "fax_number": "585-396-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHKO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02068766",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MDF311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.