Swatantra Mitta

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

133074 Issued in NY

Practice address

942A Route 146
Clifton Park, NY 12065-3614

Phone

(518) 371-8000

Fax

(518) 371-5338

NPI assigned

Oct 13, 2006

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Pediatrics

  Medicare reassignment NPD
• Community Care Physicians, PC

  dba Community Care Lab Care

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1023380714
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1871683417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942A ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-371-8000",
            "fax_number": "518-371-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTA",
        "first_name": "SWATANTRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "133074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00492017",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Earle Miller, M.D.
• Jennifer Elizabeth Miller, M.S.
• Kaeley Miller, MD
• Michelle B Miller
• Michael R. Missenis, D.C.
• Mobile Echocardiography Diagnostics LLC
• Elaina Marie Moisidis, PT, DPT
• Hana Mondelblatt, M.S.ED.
• Melissa Anne Mondesir, DMD
• Ashley Monge, PT, DPT

• Pediatrics Physician in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.