Individual provider Active NPI

Rochelle Nell Mitas, ACNP-C

  • Acute Care Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1871788570
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704212985 Issued in MI
Practice address
560 W Mitchell St
Suite #400
Petoskey, MI 49770-2275
Phone
(231) 487-2490
Fax
(231) 487-6055
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704212985 MI Primary

Addresses

Primary practice location

560 W Mitchell St
Suite #400
Petoskey, MI 49770-2275

Mailing address

560 W Mitchell St
Suite #400
Petoskey, MI 49770-2275
Phone (231) 487-2490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050910000220 MI Practitioner - Nurse Practitioner 1254363237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

560 W Mitchell St
Suite 400
Petoskey, MI 49770-2274
Phone (231) 330-3585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704212985MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

560 W Mitchell St
Petoskey, MI 49770
Phone (231) 347-7000

560 W Mitchell St
Ste 400
Petoskey, MI 49770
Phone (231) 330-3585

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

Organizations & group practices 4

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 2

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1871788570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE #400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2490",
            "fax_number": "231-487-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE #400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2490",
            "fax_number": "231-487-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITAS",
        "first_name": "ROCHELLE",
        "middle_name": "NELL",
        "credential": "ACNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704212985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.