Active NPI
Anjali Mehta, MD
- Gynecology Physician
- Bridgeport, CT
National Provider Identifier
1144329939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 029501
- Practice address
- 4749 Main St
Bridgeport, CT 06606 - Phone
- (203) 374-5013
- Fax
- (203) 374-2377
- NPI assigned
- Sep 21, 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 029501 | CT | Primary |
Addresses
Primary practice location
4749 Main St
Bridgeport, CT 06606
Mailing address
4749 Main Street
Bridgeport, CT 06606
Phone (203) 374-5013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001295014 | Medicaid | CT |
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 |
|---|---|---|---|
| 029501 | CT | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1144329939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4749 MAIN STREET",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06606",
"telephone_number": "203-374-5013",
"fax_number": "203-374-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4749 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06606",
"telephone_number": "203-374-5013",
"fax_number": "203-374-2377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "ANJALI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CT",
"license": "029501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001295014",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.