Individual provider Active NPI

Brandon Michael Mitchell, P.A.-C

  • Physician Assistant
  • Ankeny, IA
National Provider Identifier
1881683498
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001663 Issued in IA
Practice address
120 NW 36TH St
Ankeny, IA 50023-8411
Phone
(515) 358-7550
Fax
(515) 358-7551
NPI assigned
Oct 17, 2005
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001663 IA Primary

Addresses

Primary practice location

120 NW 36TH St
Ankeny, IA 50023-8411

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 358-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20051201000967 IA Practitioner - Physician Assistant 3476573619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

120 NW 36TH St
Ankeny, IA 50023-8411
Phone (515) 358-9400

2605 SW White Birch Dr
Mercyone Ankeny Prairie Trail Family Medici
Ankeny, IA 50023-7235
Phone (515) 643-7100

800 E 1St
1700 Mercyone Des Moines Diabetes Education
Ankeny, IA 50021-2100
Phone (515) 643-5203

800 E 1St St
Ankeny, IA 50021-2100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc CurrentSince Jul 1, 2006 Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

800 E 1st St
Ste 1700
Ankeny, IA 50021
Phone (515) 643-8100

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

Interoperability endpoints

  • Direct secure messaging: bmitchell3952290@direct.trinity-health.org

Organizations & group practices 3

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 5

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1881683498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-358-7550",
            "fax_number": "515-358-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NW 36TH ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500238411",
            "telephone_number": "515-358-7550",
            "fax_number": "515-358-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.