MITHILESH TAMIRISA (MD) – Internal Medicine Physician, NPI 1861486714

MITHILESH TAMIRISA (MD) is a healthcare provider. based in Rossford, Ohio. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 35050201 (OH). The NPI Number for MITHILESH TAMIRISA (MD) is 1861486714

Main info

Female
45 Years Of Experience
Accepts Medicare Assignment
Name
MITHILESH TAMIRISA (MD)
NPI
1861486714
Phone
(419) 410-4898
Address
516 RIVERSIDE DR
Enumeration Date
7 September 2005
Last Update Date
17 March 2020

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF OHIO
Secondary Phone
3307237999
Graduation Year
1981 (45 years ago)
PAC ID
7315966678
Group Practice PAC ID
1850358300
Professional Enrollment ID
I20200610002165
Address ID
OH442562181ME970XXSTXX408
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

7,199 INTERNAL MEDICINE in OH

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Provider Addresses for MITHILESH TAMIRISA (MD)

  • 516, Riverside Drive, Eagle Point Colony Historic District, Eagle Point Colony, Rossford, Wood County, Ohio, 43460, United States

    ROSSFORD, OH 434601055

    Phone: (419) 410-4898

    Fax: (419) 318-4395

    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: 2020-06-10

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
I20200610002165IInternal MedicineOHTBD

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 43460)

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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: 1850358300View full group profile
NameSpecialtyState
Nurse PractitionerOH
Geriatric Medicine, Internal MedicineOH
Internal Medicine, Pulmonary DiseaseOH
Nurse PractitionerOH
-OH
Internal MedicineOH

Reviews

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Frequently asked questions

Can I verify MITHILESH TAMIRISA (MD) with an NPI only?
You can start verification with NPI 1861486714 for MITHILESH TAMIRISA (MD), then check state licensing separately.
Can I rely on MITHILESH TAMIRISA (MD) being an active provider?
As of the registry snapshot, MITHILESH TAMIRISA (MD) is marked active.
What taxonomy line describes MITHILESH TAMIRISA (MD)?
For research purposes, treat MITHILESH TAMIRISA (MD) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is MITHILESH TAMIRISA (MD) based?
MITHILESH TAMIRISA (MD) is tied to Rossford, Ohio in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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