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MITCHELL S MCTAVISH PA-C
NPI 1386156891
Physician Assistant in Bridgeport, CT

Active since October 25, 2017PECOS Enrolled
267 GRANT ST, BRIDGEPORT, CT 06610(203) 384-3145 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 5, 2021, Oct 18, 2021, Nov 16, 2020 and 1 more (4 updates tracked since 2017).

About Mitchell S Mctavish Pa-c NPPES

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

MITCHELL S MCTAVISH PA-C (NPI 1386156891) is an individual physician assistant in Bridgeport, Connecticut, licensed in Connecticut (6716) and active in the NPI registry since October 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386156891
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMITCHELL S MCTAVISHCredential: PA-C
Location Address267 GRANT STBridgeport, CT 06610-2805
Mailing Address267 Grant StBridgeport, CT 06610-2805
Phone(203) 384-3145
Sole ProprietorNo
Enumeration DateOctober 25, 2017
Last NPPES UpdateJanuary 23, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2025
✔ NPI 1386156891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CT · 6716
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
267 GRANT ST, Bridgeport, CT 06610
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mitchell S Mctavish Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06610 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MR. ALEX SCOTT CADAN PA-C
Physician Assistant (Surgical)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4500
RYAN KEENAN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DR. BLAZE KELLY DO
Anesthesiology (Pain Medicine)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
KARINA K. LINCER
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DOROTHY D. DAPONTE
Physical Therapy Assistant
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
MISS SANDRA SHIPKOWITZ APRN
Nurse Practitioner (Pediatrics)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4490
HOLLY S. ASHBY
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
TESSA GURALNICK DPT
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3708

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Mctavish's NPI number?

The NPI number for Mitchell Mctavish is 1386156891. It was assigned to this individual provider in the NPPES registry on October 25, 2017.

Where is Mitchell Mctavish located?

Mitchell Mctavish practices at 267 Grant St, Bridgeport, CT 06610. The listed phone number is (203) 384-3145.

What is Mitchell Mctavish's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mitchell Mctavish enrolled in Medicare?

Yes. Mitchell Mctavish is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mitchell Mctavish was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.