DR. MITCHELL PETERSON CREED (MD) – Neurology with Special Qualifications in Child Neurology Physician, NPI 1659831121
Neurology with Special Qualifications in Child Neurology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,343 NEUROLOGY in NY
Provider Addresses for DR. MITCHELL PETERSON CREED (MD)
4123, West 53rd Terrace, Southridge, Roeland Park, Johnson County, Kansas, 66205, United States
ROELAND PARK, KS 662052309
Phone: (913) 544-6647
Type: Mailing
101 NICOLLS RD RM 40
STONY BROOK, NY 117940001
Phone: (631) 444-2020
Fax: (631) 444-2894
Type: Location
605 SYLVAN AVE
BAYPORT, NY 117051540
Phone: (913) 544-6647
Type: Mailing
712 MAIN ST
ISLIP, NY 117513620
Phone: (631) 666-3939
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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: 2025-06-23
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250623001776 | I | Neurology | NY | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 66205)
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