ROGER D MITTY (MD) – Gastroenterology Physician, NPI 1902894025

ROGER D MITTY (MD) is a healthcare provider. based in Brighton, Massachusetts. specializing in Gastroenterology Physician. They hold the professional credentials MD. They hold a License No. 779172 (NY). The NPI Number for ROGER D MITTY (MD) is 1902894025

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
ROGER D MITTY (MD)
NPI
1902894025
Phone
(617) 562-5432
Address
11 NEVINS ST
Enumeration Date
12 October 2005
Last Update Date
21 October 2011

Doctor Profile

Medical School Name
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6175625432
Graduation Year
1988 (38 years ago)
PAC ID
0446280978
Group Practice PAC ID
2860688728
Professional Enrollment ID
I20050815000979
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for ROGER D MITTY (MD)

  • 11, Nevins Street, Aberdeen, Brighton, Boston, Suffolk County, Massachusetts, 02135, United States

    BRIGHTON, MA 021353514

    Phone: (617) 562-5432

    Fax: (617) 789-5049

    Mailing address matches the actual address.

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: 2005-08-15

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
I20050815000979IGastroenterologyMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02135)

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Provider's Procedures

ROGER D MITTY (MD) performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GASTROENTEROLOGYMA45378Diagnostic examination of large bowel using an endoscope1818
GASTROENTEROLOGYMA45385Removal of polyps or growths of large bowel using an endoscope2121

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: 2860688728View full group profile

Reviews

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Frequently asked questions

What federal number belongs to ROGER D MITTY (MD)?
The federal identifier for ROGER D MITTY (MD) is NPI 1902894025.
Is ROGER D MITTY (MD)'s NPI currently valid?
The extract we use shows ROGER D MITTY (MD) as active.
What field does ROGER D MITTY (MD) work in?
You can think of ROGER D MITTY (MD) as practicing within Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for ROGER D MITTY (MD)?
The page summarizes Brighton, Massachusetts for ROGER D MITTY (MD); expand the address list for detail.
What if Brighton, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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