Mitchell A Brack, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35063088 Issued in OH

Practice address

793 W State St
Columbus, OH 43222-1551

Phone

(614) 234-5100

NPI assigned

Oct 20, 2005

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 1

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

Diagnostic Radiology

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-County Radiologists IncGroup PAC ID 0840241907, 25 clinicians

Radiology IncGroup PAC ID 1658274543, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Health Hospital, London, OH, CCN 360189
• Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
• Mount Carmel St Ann's Hospital, Westerville, OH, CCN 360012
• Ohio Valley Surgical Hospital Hospital, Springfield, OH, CCN 360355
• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score

81.62 of 100Reported as group

Quality

75.91

Improvement activities

40

Cost

82.89

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbrackmd1157957@direct.trinity-health.org

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.

• Radiology Inc

  • Diagnostic Radiology Physician
  • Dublin, OH
  • NPI 1609865708
  Medicare reassignment Care Compare group NPD
• Tri-County Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Newark, OH
  • NPI 1477544880
  Medicare reassignment Care Compare group NPD

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

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation
• Madison County Community Hospital

  dba Madison County Hospital

  • General Acute Care Hospital
  • London, OH
  • NPI 1982710703
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Westerville, OH
  • NPI 1417037045
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Grove City, OH
  • NPI 1710067376
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1982784534
  Care Compare affiliation
• Ohio Valley Medical Center, LLC

  • General Acute Care Hospital
  • Springfield, OH
  • NPI 1538304050
  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1982693016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT L-647",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432600001",
            "telephone_number": "866-287-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "614-234-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACK",
        "first_name": "MITCHELL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35063088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0460175",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Lauren Bozzay, PH.D.
• Ann M Braam, LISW
• Anna Martinha Braam, AUD
• Lauren Bracale
• Matthew D. Brace, M.D.
• Treyvon Brack
• Karen Brackbill, APRN-CNM
• Tara Lynn Bracken, PHARMD
• Kyle Brackenbury
• Cari C. Brackett, PHARM.D.

• Diagnostic Radiology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.