Mithilesh Tamirisa, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35050201 Issued in OH

Practice address

516 Riverside Dr
Rossford, OH 43460-1055

Phone

(419) 410-4898

NPI assigned

Sep 7, 2005

Sex

Female

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

Other names 1

• Mitzi Tamirisa Other name

Medicare fee-for-service enrollment

Enrolled in OH

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

Internal Medicine

Education

Medical College of Ohio, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A and S Khandelwal MD IncGroup PAC ID 1850358300, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtamirisa@askhandelwal.medentdirect.com

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.

• A & S Khandelwal MD Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Medina, OH
  • NPI 1487702718
  Medicare reassignment Care Compare group NPD
• Ohio Living Palliative Care Greater Toledo LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1861981656
  Medicare reassignment NPD

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1861486714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 RIVERSIDE DR",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601055",
            "telephone_number": "419-410-4898",
            "fax_number": "419-318-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 RIVERSIDE DR",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601055",
            "telephone_number": "419-410-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMIRISA",
        "first_name": "MITHILESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35050201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0628888",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITZI",
            "last_name": "TAMIRISA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Stratoti
• Sarah Strausbaugh
• Aaron Summerskill
• Hannah Elizabeth Swartz
• Linda Szilagye, LPN
• Celestine Taylor
• Shamari Taylor
• Shamya M Taylor
• The Tamarkin Company
• Brittney Lynn Tillett

• Internal Medicine Physician in Rossford, OH
• Providers in Rossford, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.