Mitzi Regala, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

62647-20 Issued in WI

Practice address

2977 Cty Hwy CX
Portage, WI 53901

Phone

(608) 742-3004

Fax

(608) 742-2399

NPI assigned

Aug 23, 2010

Sex

Female

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 OH

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

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
• Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD

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

• Cleveland Clinic Health System - East Region

  • General Acute Care Hospital
  • Mayfield HTS, OH
  • NPI 1902858152
  Care Compare affiliation
• Marymount Hospital Inc

  • General Acute Care Hospital
  • Garfield Heights, OH
  • NPI 1942248737
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419552000000",
    "number": "1932415403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 CTY HWY CX",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "53901",
            "telephone_number": "608-742-3004",
            "fax_number": "608-742-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGALA",
        "first_name": "MITZI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2014-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "62647-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "421527584",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255339750",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Ranum, LCSW
• Bryan Rastello
• Marjorie Rau
• Brittany Leigh Read, CCC-SLP
• Elizabeth Sharron Reddeman, DPT
• Ashleigh Reimer, MOT, OTR/L
• Renewal Unlimited, Inc.
• Rest Assured Home Health Care LLC
• Riverside Home Care LLC
• Philip W Robinson

• Family Medicine Physician in Portage, WI
• Providers in Portage, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.