Active NPI
Ila N Mehta III, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Cincinnati, OH
National Provider Identifier
1053390807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 35040388
- Practice address
- 375 Dixmyth Ave
Cincinnati, OH 45220-2475 - Phone
- (513) 624-4337
- NPI assigned
- Jan 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 35040388 | OH | Primary |
Addresses
Primary practice location
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Mailing address
PO Box 632242
Cincinnati, OH 45263-2242
Phone (800) 503-6254
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200234420F | Medicaid | IN | |
| 64935885 | Medicaid | KY | |
| 200234420C | Medicaid | IN | |
| 220014349 | Other | RAILROAD MEDICARE | |
| 200234420E | Medicaid | IN | |
| 0404584 | Medicaid | OH | |
| 200234420D | Medicaid | IN | |
| 200234420A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35040388 | OH | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1053390807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 632242",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452632242",
"telephone_number": "800-503-6254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 DIXMYTH AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452202475",
"telephone_number": "513-624-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "ILA",
"middle_name": "N",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-11",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OH",
"license": "35040388",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200234420F",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64935885",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200234420C",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "220014349",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200234420E",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0404584",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200234420D",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200234420A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.