Elizabeth Mittendorf, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

273553 Issued in MA

Practice address

75 Francis St
Boston, MA 02115-6110

Phone

(617) 632-2174

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Surgical Oncology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, 1,693 clinicians

Dana-Farber Cancer Institute, Inc.Group PAC ID 9133038904, 671 clinicians

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162
• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
• Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
• Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mittendorf.elizabeth.bwh@direct.partners.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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group NPD
• Dana-Farber Cancer Institute, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1851333686
  Medicare reassignment Care Compare group NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1194765438
  Medicare reassignment Care Compare group NPD
• Brigham and Women'S Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD
• Dana-Farber Cancer Institute, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Chestnut Hill, MA
  • NPI 1497429237
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1043250616
  NPD (past)

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

• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Care Compare affiliation
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1578677811
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc.

  • Psychiatric Hospital Unit
  • Boston, MA
  • NPI 1033121025
  Care Compare affiliation
• Dana-Farber Cancer Institute, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1851333686
  Care Compare affiliation

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1831288596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BOYLSTON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456007",
            "telephone_number": "857-307-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-632-2174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304009",
            "country_code": "US",
            "telephone_number": "713-792-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTENDORF",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "M1941",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MA",
            "license": "273553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177303801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arjun Mittal, MD
• Leena P Mittal, M.D.
• Andrew T. Mittelman, MD
• Rachel Nicole Mittelstaedt, MD
• Emilie Kavanagh Mitten, M.D.
• Murray Allan Mittleman, M.D.
• Julian A Mitton, MD
• Matthew Mitton
• Lyle D Mitzner, M.D.
• Koji Miwa, MD

• Surgical Oncology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Surgical Oncology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.