NPIMap

Individual provider Active NPI

Brian James Mitchell, DO

  • Otolaryngology/Facial Plastic Surgery Physician
  • Puyallup, WA
National Provider Identifier
1942491196
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
OP00002336 Issued in WA
Practice address
104 27TH Ave SE
Puyallup, WA 98374-1145
Phone
(253) 770-9000
Fax
(253) 770-9712
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X OP00002336 WA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X OP00002336 WA Primary

Addresses

Primary practice location

104 27TH Ave SE
Puyallup, WA 98374-1145

Mailing address

PO Box 1205
Puyallup, WA 98371-0231
Phone (253) 770-9000

Other practice location 1

217 W Cataldo
Spokane, WA 99201
Phone (509) 624-2326

Other identifiers 1

IdentifierTypeStateIssuer
2006500MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080714000217 WA Practitioner - Otolaryngology 6305919093 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP00002336WAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc PS CurrentSince Dec 27, 2020 Accepting new patients
Multicare Health System CurrentSince Oct 13, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Columbia Surgical Specialists, PS CurrentSince Aug 4, 2008 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Multicare Health System CurrentSince Oct 13, 2021 Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology CurrentSince Dec 15, 2020 Accepting new patients
Columbia Surgical Specialists, PS Otolaryngology CurrentSince Aug 4, 2008 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Dec 15, 2020 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

217 W Cataldo Ave
Spokane, WA 99201
Phone (509) 624-2326

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: bmitchell350680@direct.multicare.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1942491196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710231",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 W Cataldo",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "99201",
            "country_code": "US",
            "telephone_number": "509-624-2326",
            "fax_number": "509-744-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "OP00002336",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "OP00002336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006500",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.