MEHTAB MIZAN (MD) – Internal Medicine Physician, NPI 1104976380

MEHTAB MIZAN (MD) is a healthcare provider. based in Urbana, Illinois. specializing in HOSPITALIST, INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 036098942 (IL). The NPI Number for MEHTAB MIZAN (MD) is 1104976380

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
MEHTAB MIZAN (MD)
NPI
1104976380
Phone
(217) 383-6792
Address
611 W PARK ST
Enumeration Date
11 January 2007
Last Update Date
6 May 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172835531
Graduation Year
1996 (30 years ago)
PAC ID
8123003548
Group Practice PAC ID
3577456037
Professional Enrollment ID
I20040621001052
Address ID
IL609421801HO701XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,392 HOSPITALIST in IL

Loading map...

Provider Addresses for MEHTAB MIZAN (MD)

  • Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States

    BWPC

    URBANA, IL 618012529

    Phone: (217) 383-6792

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040621001052IInternal MedicineILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes384194$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes258168$0
99239Hospital discharge day management, more than 30 minutes193189$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes3535$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1616$0
View full utilization report →

Insurance plans in this area (ZIP 61801)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577456037View full group profile
NameSpecialtyState
Internal Medicine, HospitalistIL
Nurse PractitionerIL
Internal Medicine, Family PracticeIL
-IL
Nurse PractitionerIL
Internal MedicineIL
Internal Medicine, Cardiovascular Disease (Cardiology)IL
Physician AssistantIL
Family Practice, Emergency MedicineIL
General SurgeryIL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What NPI should I save for MEHTAB MIZAN (MD)?
Save NPI 1104976380 if you need a stable reference for MEHTAB MIZAN (MD).
Does this profile mean MEHTAB MIZAN (MD) is currently active?
Yes — MEHTAB MIZAN (MD) appears active in the national provider directory.
Does MEHTAB MIZAN (MD) list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for MEHTAB MIZAN (MD). Clinical services aligned with this taxonomy classification.
Does MEHTAB MIZAN (MD) practice in Illinois?
You will see Urbana, Illinois on file for MEHTAB MIZAN (MD) alongside any extra practice locations.
How can I contact MEHTAB MIZAN (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

Similar Providers

DR. ERLANDAS ULOZAS (MD)

Nephrology Physician
Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States
NPI: 1699774158

DR. AHMED TAREK ELRAKHAWY (M.D.)

Internal Medicine Physician
611 W PARK ST
NPI: 1306838503

SARAH LOVINGER (MD)

Internal Medicine Physician
Belvidere Road, Wilson, Waukegan, Lake, Illinois, 60085, United States
NPI: 1003894353

SAUMYADIP DASGUPTA (MD)

Cardiovascular Disease Physician
2300 N. Vermilion Ave.
NPI: 1346215696

DR. SHAMIM SADIQ (M.D.)

Internal Medicine Physician
101, West University Avenue, Champaign, Champaign County, Illinois, 61820, United States
NPI: 1801862461
Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States
NPI: 1083675045

CARLE CLINIC ASSOCATION, P.C.

Internal Medicine Physician
602, West University Avenue, Downtown Urbana, Urbana, Champaign County, Illinois, 61801, United States
NPI: 1255380846

DR. RONNIE F LUYUN (MD)

Medical Oncology Physician
Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States
NPI: 1346291960

DR. ROBERT G GOOD (DO)

Internal Medicine Physician
200 LERNA ROAD SOUTH
NPI: 1639122922