Maitri Mehta, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A22966 Issued in CA

Practice address

1650 Los Gamos Dr
San Rafael, CA 94903-1850

Phone

(415) 444-2000

NPI assigned

May 6, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Pacific NW Un of HS, Col of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1003490921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LOS GAMOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031850",
            "telephone_number": "415-444-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LOS GAMOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031850",
            "telephone_number": "415-444-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S Hennepin Ave",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "610213013",
            "country_code": "US",
            "telephone_number": "815-285-8520",
            "fax_number": "815-285-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MAITRI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22966",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-078487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1650 Los Gamos Dr",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949031850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lucienne Meckfessel
• Medical Business Systems, Inc
• Deliris Limary Medina, PSYD
• William James Meecham, MD
• Adnan Meesa
• Marc R. Meisner, MD
• Gisselle Mejia
• Jennifer Mejia
• Melissa E Rinck DDS Apc
• Shanley B. Melody

• Family Medicine Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.