Mitchell I. Conn, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD029191E Issued in PA

Practice address

132 S 10TH St
480 Main Building
Phila, PA 19107-5244

Phone

(215) 955-8900

Fax

(215) 955-5245

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Gastroenterology

Education

New York University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mount Nittany Medical Center Health Services Inc

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554
  Medicare reassignment Care Compare group NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD
• Dimarino-Kroop-Prieto Gastro-Intestinal Associates,PA

  • Specialist
  • Woodbury, NJ
  • NPI 1962422295
  Medicare reassignment NPD
• South Jersey Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Woodbury, NJ
  • NPI 1689633588
  NPD (past) Authorized official
• Dimarino-Kroop-Prieto Gastro Intestinal Associates PA

  • Specialist
  • Woodbury, NJ
  • NPI 1104888080
  NPD
• Mount Nittany Medical Center Health Services Inc

  • Pain Clinic/Center
  • State College, PA
  • NPI 1407035553
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Nittany Medical Center

  • Pain Clinic/Center
  • State College, PA
  • NPI 1104991801

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Clinic/Center
  • State College, PA
  • NPI 1194521302

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • General Acute Care Hospital
  • State College, PA
  • NPI 1730173154
  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780750620

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780752378

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1922067917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "480 MAIN BUILDING",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-955-8900",
            "fax_number": "215-955-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "480 MAIN BUILDING",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-955-8900",
            "fax_number": "215-955-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Greenview Drive",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168032106",
            "country_code": "US",
            "telephone_number": "814-278-4631",
            "fax_number": "814-278-4685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 S Atherton St Ste 2",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168018324",
            "country_code": "US",
            "telephone_number": "814-278-4631",
            "fax_number": "814-278-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONN",
        "first_name": "MITCHELL",
        "middle_name": "I.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD029191E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013981880005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4559401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Lloyd Coleman, M.D.
• Lisa Colton
• Comfort Assistance Living & Transport LLC
• John Victor Compher, LCSW
• Comprehensive Internal Medicine Associates
• Victoria L. Conrad, MSN, CRNP
• Patricia Constant
• Constantly Caring Home Care LLC
• Tia Latosha Cook
• Elizabeth Michaela Cooke

• Gastroenterology Physician in Phila, PA
• Providers in Phila, PA by specialty
• Gastroenterology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.

Verify at the official NPI Registry.