Michael D Mitchell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

162887 Issued in NY

Practice address

51 Glasgow Ave.
Jamestown, NY 14701

Phone

(716) 664-8604

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Chautauqua Hospice and Palliative Care

  • Community Based Hospice Care Agency
  • Lakewood, NY
  • NPI 1639255250

  Family Medicine

  Medicare reassignment NPD
• Gerry Homes Inc

  • Skilled Nursing Facility
  • Greenhurst, NY
  • NPI 1003812330
  NPD
• Gerry Homes Inc

  • Skilled Nursing Facility
  • Jamestown, NY
  • NPI 1366448706
  NPD
• Gerry Nursing Home Company

  • Skilled Nursing Facility
  • Gerry, NY
  • NPI 1164409801
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1922082197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5945 DAMON HILL RD",
            "city": "SINCLAIRVILLE",
            "state": "NY",
            "postal_code": "147829728",
            "telephone_number": "716-397-0814",
            "fax_number": "716-338-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 GLASGOW AVE.",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-664-8604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 W Fairmount Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "NY",
            "postal_code": "147501702",
            "country_code": "US",
            "telephone_number": "716-338-0033 x223",
            "fax_number": "716-338-1575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "162887",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "162887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00902103",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory M Miller
• Kayleigh Marie Milliman
• Barbara Mincarelli, MD
• Mission Hearing, LLC
• Charles W Mistretta, DPM
• Phalguni Mitra, DDS
• Anthony Ansar Mohamed, M.D.
• Mohammad M Bari Physician PC
• Henry W Mole', O.D.
• Brooke Helen Moller, LCSW

• Family Medicine Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.