Active NPI
David Mitchell, O.D.
- Optometrist
- Thibodaux, LA
National Provider Identifier
1912908658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1411-553T
- Practice address
- 425 Saint Mary St
Thibodaux, LA 70301-2641 - Phone
- (985) 447-2393
- NPI assigned
- Aug 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1411-553T | LA | Primary |
| Pediatric Optometrist | 152WP0200X | 1411-553T | LA | |
| Vision Therapy Optometrist | 152WV0400X | 1411-553T | LA | |
| Corneal and Contact Management Optometrist | 152WC0802X | 1411-553T | LA | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 1411-553T | LA |
Addresses
Primary practice location
425 Saint Mary St
Thibodaux, LA 70301-2641
Mailing address
425 Saint Mary St
Thibodaux, LA 70301-2641
Phone (985) 447-2393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1507032 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
425 Saint Mary St
Thibodaux, LA 70301-2641
Phone (985) 447-2393
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1411-553T | LA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Vision Center | Pediatrics | Current | Accepting new patients |
| Mitchell Eye Care Associates, L.L.C. | Optometrist | Current | Accepting new patients |
Locations
425 Saint Mary St
Thibodaux, LA 70301
Phone (985) 228-1233
Organizations & group practices 2
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.
-
- Optometrist
- Thibodaux, LA
- NPI 1568415776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1912908658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 SAINT MARY ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703012641",
"telephone_number": "985-447-2393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 SAINT MARY ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703012641",
"telephone_number": "985-447-2393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-03",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "LA",
"license": "1411-553T",
"primary": true
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "LA",
"license": "1411-553T",
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "LA",
"license": "1411-553T",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "LA",
"license": "1411-553T",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "LA",
"license": "1411-553T",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1507032",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Thibodaux, LA
- Millers Care Coordination & Behavioral Health, LLC
- Mindful Matters Counseling Services
- Brittany Trosclair Mire, APRN,FNP-C, PMHNP-BC
- Mary Elaine Mire, RPH
- Mitchell Eye Care Associates, L.L.C.
- Lisa L Mitchell, OD
- James Kevin Modisette, M.D.
- Joshua Moffett, LPC
- George Molaison, LPC, M.A.
- Eriyanne Breshon Mollere
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.