DR. JONATHAN MITRY MD, MSC
NPI 1104406974
Student in an Organized Health Care Education/Training Program in Pasadena, CA

Active since April 14, 2021PECOS EnrolledAccepts Medicare Assignment
3280 E FOOTHILL BLVD, PASADENA, CA 91107(833) 574-2273 Get Directions Write a Review

NPPES record last updated: July 11, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 11, 2024, Dec 15, 2021, Apr 14, 2021 (3 updates tracked since 2021).

About Dr. Jonathan Mitry Md, Msc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN MITRY MD, MSC (NPI 1104406974) is an individual student in an organized health care education/training program in Pasadena, California and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1104406974
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JONATHAN MITRYCredential: MD, MSC
Location Address3280 E FOOTHILL BLVDPasadena, CA 91107-3148
Mailing Address3280 E Foothill BlvdPasadena, CA 91107-3148
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 14, 2021
Last NPPES UpdateJuly 11, 20243 updates tracked since enumeration
NPPES CertifiedJuly 11, 2024
NPI 1104406974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3280 E FOOTHILL BLVD, Pasadena, CA 91107

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jonathan Mitry Md, Msc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315397726
PECOS Enrollment IDI20231227003165
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
3280 E FOOTHILL BLVD, 4TH FLOOR
PASADENA, CA 91107
Family Medicine
3280 E FOOTHILL BLVD
PASADENA, CA 91107
Physical Therapist (Orthopedic)
3280 E FOOTHILL BLVD
PASADENA, CA 91107
Social Worker (Clinical)
3280 E FOOTHILL BLVD, 2ND FLOOR
PASADENA, CA 91107
Pharmacist
3280 E FOOTHILL BLVD, OUTPATIENT PHARMACY FIRST FLOOR
PASADENA, CA 91107
Pharmacist
3280 E FOOTHILL BLVD, OUT PATIENT PHARMACY
PASADENA, CA 91107
Pharmacist
3280 E FOOTHILL BLVD, OUTPATIENT PHARMCY
PASADENA, CA 91107
Pharmacist
3280 E FOOTHILL BLVD
PASADENA, CA 91107

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104406974, enumerated as an "individual" on April 14, 2021.

The provider is located at 3280 E FOOTHILL BLVD PASADENA, CA 91107 and the phone number is (833) 574-2273.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.