Active NPI
Sunil Mehra, MD
- Pediatrics Physician
- Fairfield, CT
National Provider Identifier
1134421118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 236235
- Practice address
- 1175 Stillson Rd
Fairfield, CT 06824-3017 - Phone
- (647) 267-5665
- NPI assigned
- Nov 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA07716700 | NJ | |
| Pediatrics Physician | 208000000X | 236235 | NY | Primary |
Addresses
Primary practice location
1175 Stillson Rd
Fairfield, CT 06824-3017
Mailing address
1175 Stillson Rd
Fairfield, CT 06824-3017
Phone (647) 267-5665
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07716700 | NJ | MD | Pediatrics Physician |
| 236235 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1134421118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 STILLSON RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068243017",
"telephone_number": "647-267-5665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 STILLSON RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068243017",
"telephone_number": "647-267-5665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHRA",
"first_name": "SUNIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-24",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA07716700",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "236235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.