Individual provider Active NPI

Robin U. Michitsch, D.O.

  • Anesthesiology Physician
  • Jefferson City, MO
National Provider Identifier
1891780482
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
103378 Issued in MO
Practice address
1445 Christy Dr
Jefferson City, MO 65101-2853
Phone
(573) 636-3483
Fax
(573) 636-5315
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 103378 MO Primary
Interventional Pain Medicine Physician 208VP0014X 103378 MO

Addresses

Primary practice location

1445 Christy Dr
Jefferson City, MO 65101-2853

Mailing address

1445 Christy Dr
Jefferson City, MO 65101-2853
Phone (573) 636-3483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040123000390 MO Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 8729980388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Missouri Anesthesia Consultants PCGroup PAC ID 8224025747, 13 clinicians

Practice addresses (Care Compare)

1705 Christy Dr
Jefferson City, MO 65101-5195
Phone (573) 635-7022

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103378MOMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Missouri Anesthesia Consultants PC Anesthesiology CurrentSince Jun 1, 1995 Accepting new patients

Locations

3349 American Ave
Ste C
Jefferson City, MO 65109
Phone (573) 635-9480

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

1445 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 636-3483

1705 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 289-9619

Organizations & group practices 1

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 1

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1891780482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 CHRISTY DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012853",
            "telephone_number": "573-636-3483",
            "fax_number": "573-636-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 CHRISTY DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012853",
            "telephone_number": "573-636-3483",
            "fax_number": "573-636-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHITSCH",
        "first_name": "ROBIN",
        "middle_name": "U.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "103378",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MO",
            "license": "103378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.