NPIMap

Individual provider Active NPI

Blaine Parrish Mitchell, DO

  • Diagnostic Radiology Physician
  • Hollywood, FL
National Provider Identifier
1831114685
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS9735 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 437-4800
Fax
(954) 437-6628
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H77682 MD
Diagnostic Radiology Physician 2085R0202X OS9735 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

500 N Hiatus Rd Ste 200
Pembroke Pines, FL 33026-5213
Phone (954) 437-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mblaine151184@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070915000201 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2466546833 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Radiology Associates LLCGroup PAC ID 2769829522, 74 clinicians
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians

Practice addresses (Care Compare)

17021 US Hwy 441
Mount Dora, FL 32757-6734
Phone (317) 614-9881

420 Alexandra Cir
Weston, FL 33326-3308
Phone (540) 741-5610

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022
  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028
  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
  • Stafford Hospital, LLC Hospital, Stafford, VA, CCN 490140

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H77682MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Feb 1, 2024 Accepting new patients
Nuvance Health Medical Practice PC CurrentSince Dec 1, 2025 Accepting new patients
Florida Radiology Associates LLC Diagnostic Radiology CurrentSince Apr 1, 2024 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Feb 4, 2023 Accepting new patients
Mary Washington Healthcare Providers LLC Diagnostic Radiology CurrentSince Sep 1, 2025 Accepting new patients
Madison Radiologists S C Diagnostic Radiology PastSince Feb 15, 2025 Accepting new patients
Radiology Associates of Hollywood, Inc. Diagnostic Radiology Past Accepting new patients
Marquette General Hospital, Inc. Diagnostic Radiology Past Accepting new patients
Excalibur Medical Imaging, LLC Diagnostic Radiology Past Accepting new patients

Locations

17021 US Highway 441
Mount Dora, FL 32757
Phone (352) 323-5762

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

500 N Hiatus Rd
Ste 200
Pembroke Pines, FL 33026
Phone 9544374800 ext. 2133

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Interoperability endpoints

  • Direct secure messaging: mblaine151184@mhsdirect.net
  • Direct secure messaging: bmitchell709767@direct.shands.ufl.edu
  • Direct secure messaging: bmitchell141177@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 9

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1831114685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD STE 200",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-437-4800",
            "fax_number": "954-437-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-437-4800",
            "fax_number": "954-437-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BLAINE",
        "middle_name": "PARRISH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "H77682",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS9735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblaine151184@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.