Mehak Bansal, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

96697 Issued in GA

Practice address

1057 Main St
Forest Park, GA 30297-1482

Phone

(404) 301-4555

Fax

(404) 301-4482

NPI assigned

Apr 30, 2020

Reactivated

Jan 25, 2022

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbansal2016860@direct.trinity-health.org

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

• PMR Georgia Holding, LLC

  dba Jencare Neighborhood Medical Center

  • Specialist
  • Miami Gardens, FL
  • NPI 1609329630

  GA

  Medicare reassignment NPD
• PMR Georgia Holding, LLC

  dba Jencare Senior Medical Center Forest Park

  • Non-Pharmacy Dispensing Site
  • Forest Park, GA
  • NPI 1164194858
  NPD
• Jencare Neighborhood Medical Center West End, LLC

  • Specialist
  • Atlanta, GA
  • NPI 1366783524
  NPD (past)

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1013538040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 MAIN ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971482",
            "telephone_number": "404-301-4555",
            "fax_number": "404-301-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 MAIN ST",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971482",
            "telephone_number": "404-301-4555",
            "fax_number": "404-301-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "MEHAK",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "deactivation_date": "2022-01-11",
        "reactivation_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "96697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Internal Medicine Group, Inc.
• Atlanta Medical Professional Group
• Back 2 Health LLC
• Bakers Field Supplies
• Melva L Banks, FNP-C
• Barbour Orthopaedics & Sports Medicine PC
• Basden Family Practice, Inc.
• Deborah Ann Beal, DDS
• Bonserva Acute Primary Care Center
• Robin Lynn Boston, B.S., PP

• Internal Medicine Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.