Individual provider Active NPI

Tiffany Mitchell, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871956672
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
303718 Issued in CA
Practice address
4121 Santa Monica Blvd Ste 106
Los Angeles, CA 90029-2270
Phone
(213) 335-7355
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 303718 CA Primary

Addresses

Primary practice location

4121 Santa Monica Blvd Ste 106
Los Angeles, CA 90029-2270

Mailing address

1820 E Calaveras St
Altadena, CA 91001-3312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200604003095 NY Practitioner - Emergency Medicine 8628499324 Reassigns benefits to 3 organizations
I20260401000253 CA Practitioner - Emergency Medicine 8628499324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303718CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Jacobi Medical Center Ed Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1871956672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E CALAVERAS ST",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 SANTA MONICA BLVD STE 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292270",
            "telephone_number": "213-335-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TIFFANY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "303718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.