Individual provider Active NPI

Vivek Mukur Mehta, MD

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1114187614
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
46083 Issued in AZ
Practice address
2222 E Highland Ave
Suite 300
Phoenix, AZ 85016-4872
Phone
(602) 277-6211
Fax
(866) 242-5309
NPI assigned
Jun 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 46083 AZ Primary

Addresses

Primary practice location

2222 E Highland Ave
Suite 300
Phoenix, AZ 85016-4872

Mailing address

2222 E Highland Ave
Suite 300
Phoenix, AZ 85016-4872
Phone (602) 277-6211

Other identifiers 2

IdentifierTypeStateIssuer
706184MedicaidAZ
46083OtherAZAZ LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131216000775 NY Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 4981851342 Reassigns benefits to 1 organization
I20220317001801 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 4981851342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Pain Care PCGroup PAC ID 5597950154, 4 clinicians
New Jersey Pain Care Center PCGroup PAC ID 4486703121, 4 clinicians

Practice addresses (Care Compare)

41 5TH Ave
Suite 1A1B
New York, NY 10003-4319
Phone (212) 604-1300

44 State RT
23 Suite 15B
Riverdale, NJ 07457-1603
Phone (973) 400-1716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46083AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Pain Care Center PC CurrentSince Mar 3, 2022 Accepting new patients
New Jersey Pain Care Center PC Physical Medicine & Rehabilitation CurrentSince Mar 3, 2022 Accepting new patients
Chelsea Anesthesia, LLC Past Accepting new patients

Locations

44 State Rt 23
Ste 15B
Riverdale, NJ 07457
Phone (973) 400-1716

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1114187614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-277-6211",
            "fax_number": "866-242-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-277-6211",
            "fax_number": "866-242-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "VIVEK",
        "middle_name": "MUKUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "46083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706184",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE #",
            "identifier": "46083",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.