Individual provider Active NPI

Peter Nathanael Mittwede, M.D., PH.D.

  • Orthopaedic Surgery Physician
  • Madison, MS
National Provider Identifier
1881045748
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD469401 Issued in PA
Practice address
401 Baptist Dr Ste 301
Madison, MS 39110-2012
Phone
(601) 973-1571
Fax
(601) 973-1577
NPI assigned
Jun 22, 2016
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD469401 PA Primary

Addresses

Primary practice location

401 Baptist Dr Ste 301
Madison, MS 39110-2012

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Phone (877) 348-1281

Other practice location 1

3471 5th Ave
911 L.S. Kaufmann Building
Pittsburgh, PA 15213-3215
Phone (601) 421-5715

Other practice location 2

1200 N State St Ste 500
Jackson, MS 39202-2027
Phone (601) 352-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20230906002057 MS Practitioner - Orthopedic Surgery 1658770896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

401 Baptist Dr
Suite 301
Madison, MS 39110-2012
Phone (601) 973-1571

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Nov 23, 2024 Accepting new patients
Medical Foundation of Central Ms CurrentSince Nov 23, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 5, 2023 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Sep 5, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
BMC - Attala, LLC PastSince Dec 22, 2024 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273

401 Baptist Dr
Ste 301
Madison, MS 39110
Phone (601) 973-1571

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

326 Commerce Center Dr
Ste 1200
Ridgeland, MS 39157

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Interoperability endpoints

  • Direct secure messaging: pmittwede27855@ummc.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1881045748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281",
            "fax_number": "901-227-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012",
            "telephone_number": "601-973-1571",
            "fax_number": "601-973-1577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3471 5th Ave",
            "address_2": "911 L.S. Kaufmann Building",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152133215",
            "country_code": "US",
            "telephone_number": "601-421-5715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N State St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022027",
            "country_code": "US",
            "telephone_number": "601-352-2273",
            "fax_number": "601-353-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTWEDE",
        "first_name": "PETER",
        "middle_name": "NATHANAEL",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD469401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.