Individual provider Active NPI

Sachi Mehta

  • Physician Assistant
  • Newberry, FL
National Provider Identifier
1134618093
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112399 Issued in FL
Practice address
215 NW 138TH Ter
Newberry, FL 32669-2090
Phone
(352) 332-2345
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006515 IL
Physician Assistant 363A00000X PA9112399 FL Primary

Addresses

Primary practice location

215 NW 138TH Ter
Newberry, FL 32669-2090

Mailing address

9748 NW 25TH PL Apt 202
Gainesville, FL 32606-0082
Phone (352) 857-3922

Other practice location 1

6620 Barrington Rd
Hanover Park, IL 60133-3935
Phone (630) 830-5926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200306001709 FL Practitioner - Physician Assistant 0749618668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085006515ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Feb 18, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Feb 18, 2020 Accepting new patients
Dr. B'S Kids, PA PastSince May 17, 2020 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100371
Gainesville, FL 32610
Phone (352) 265-8335

Organizations & group practices 3

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1134618093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9748 NW 25TH PL APT 202",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326060082",
            "telephone_number": "352-857-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NW 138TH TER",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692090",
            "telephone_number": "352-332-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6620 Barrington Rd",
            "address_purpose": "LOCATION",
            "city": "Hanover Park",
            "state": "IL",
            "postal_code": "601333935",
            "country_code": "US",
            "telephone_number": "630-830-5926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SACHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006515",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, FL

Sources for this page

Verify at the official NPI Registry.