Shilpa Mehta

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-110523 Issued in IL

Practice address

1505 Eastland Dr
Bloomington, IL 61701-3534

Phone

(309) 663-2100

Fax

(309) 663-8322

NPI assigned

Oct 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Javon Bea Hospital Hospital, Rockford, IL, CCN 140239
• Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smehtamd357039@carlehiedirect.net

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group NPD
• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment Care Compare group NPD
• Carle Bromenn Medical Center

  • Clinic/Center
  • Normal, IL
  • NPI 1104442615
  Medicare reassignment NPD
• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  Care Compare affiliation
• Javon Bea Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1629118609
  Care Compare affiliation
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1174616411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-2100",
            "fax_number": "309-663-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-2100",
            "fax_number": "309-663-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SHILPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-110523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "833120",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110523",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Meany, LPC
• Joanne Lillian Mecherle
• Medical Hills Internists
• Medical Hills Internists,LLC
• Medsource LLC
• Mary A Meismer, OTR/L, CHT (NBCOT)
• Teresa Dawn Mejorado, PA-C
• Juan Rafael Mendoza Ortiz, MD
• Rebecca Mengarelli, OTR/L
• Mental Health and Deafness Resources

• Family Medicine Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.