Organization Active NPI

Spiros Mitsopoulos, MD, PLLC

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1891130845
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7454 Issued in NH
Legal business name
SPIROS MITSOPOULOS, MD, PLLC
Practice address
445 Cypress St
Unit 9
Manchester, NH 03103-3600
Phone
(603) 663-8230
Fax
(603) 663-8239
NPI assigned
May 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Spiros Mitsopoulos, M.D.NPI 1720034390
Title
Physician Owner
Phone
(603) 663-8230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 7454 NH Primary

Addresses

Primary practice location

445 Cypress St
Unit 9
Manchester, NH 03103-3600

Mailing address

445 Cypress St
Unit 9
Manchester, NH 03103-3600
Phone (603) 663-8230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130903000626 NH Part B Supplier - Clinic/Group Practice 2163665589 Receives reassigned benefits from 1 practitioner
Practice locations: Manchester, NH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D2059660Spiros Mitsopoulos, MD, PLLC445 Cypress St, # 9, Manchester, NH 03103Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1891130845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST",
            "address_2": "UNIT 9",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-663-8230",
            "fax_number": "603-663-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CYPRESS ST",
            "address_2": "UNIT 9",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033600",
            "telephone_number": "603-663-8230",
            "fax_number": "603-663-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIROS MITSOPOULOS, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "MITSOPOULOS",
        "authorized_official_first_name": "SPIROS",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "603-663-8230",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "7454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.