Individual provider Active NPI

Mitchell Wayne Cox, M.D.

  • Vascular Surgery Physician
  • Galveston, TX
National Provider Identifier
1962571919
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
L6849 Issued in TX
Practice address
1005 Harborside Drive
5TH Floor
Galveston, TX 77555
Phone
(409) 772-6787
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0061353 MD
Surgery Physician 208600000X 2008-00651 NC
Vascular Surgery Physician 2086S0129X 2008-00651 NC
Vascular Surgery Physician 2086S0129X L6849 TX Primary

Addresses

Primary practice location

1005 Harborside Drive
5TH Floor
Galveston, TX 77555

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265-0859
Phone (409) 266-5992

Other practice location 1

8600 Old Georgetown Rd
Bethesda, MD 20814-1422
Phone (301) 896-6762

Other identifiers 1

IdentifierTypeStateIssuer
415096100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20090326000461 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 6305930165 Reassigns benefits to 1 organization
I20220511002811 TX Practitioner - Vascular Surgery 6305930165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Case Western University School of Dental Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

1005 Harborside Dr FL
Suite 5
Galveston, TX 77555-0001
Phone (409) 772-6781

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)15
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061353MDMDSpecialist
2008-00651NCMDSurgery Physician
L6849TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Physician Services CurrentSince Feb 3, 2021 Accepting new patients
Southeastern Regional Physician Services CurrentSince Feb 3, 2021 Accepting new patients
Utmb Faculty Group Practice Surgery CurrentSince May 3, 2022 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients
Premier Physician Group, LLC Surgery Past Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

403 W 27th St
Lumberton, NC 28358
Phone (919) 671-6619

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

2936 N Elm St
#102
Lumberton, NC 28358
Phone (910) 671-6619

395 W 27th St
Lumberton, NC 28358
Phone (910) 738-3434

812 Candy Park Rd
Ste 5103
Pembroke, NC 28372
Phone (910) 671-6619

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

146 E Hospital Dr
Ste 205
Angleton, TX 77515
Phone (281) 277-5200

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

1005 Harborside Dr
Galveston, TX 77555
Phone (409) 772-0122

1005 Harborside Dr
Fl 5
Galveston, TX 77555
Phone (409) 747-3376

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

250 Blossom St
Fl 4
Webster, TX 77598
Phone (409) 772-3695

Interoperability endpoints

  • Direct secure messaging: mcox55060@direct.utmb.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1962571919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650859",
            "telephone_number": "409-266-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HARBORSIDE DRIVE",
            "address_2": "5TH FLOOR",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77555",
            "telephone_number": "409-772-6787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 Old Georgetown Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208141422",
            "country_code": "US",
            "telephone_number": "301-896-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COX",
        "first_name": "MITCHELL",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0061353",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2008-00651",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2008-00651",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "L6849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415096100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.