Individual provider Active NPI

Jigna N. Mehta, PA-C

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1174638738
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16267 Issued in CA
Practice address
2740 S Bristol St
Suite 208
Santa Ana, CA 92704-6209
Phone
(714) 979-5734
Fax
(714) 979-5781
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16267 CA Primary

Addresses

Primary practice location

2740 S Bristol St
Suite 208
Santa Ana, CA 92704-6209

Mailing address

2740 S Bristol St
Suite 208
Santa Ana, CA 92704-6209
Phone (714) 979-5734

Other identifiers 1

IdentifierTypeStateIssuer
PA16267MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050510000877 CA Practitioner - Physician Assistant 5890735773 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16267CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Amistad Multi Specialty Medical Group Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1174638738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 S BRISTOL ST",
            "address_2": "SUITE 208",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046209",
            "telephone_number": "714-979-5734",
            "fax_number": "714-979-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S BRISTOL ST",
            "address_2": "SUITE 208",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046209",
            "telephone_number": "714-979-5734",
            "fax_number": "714-979-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "JIGNA",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA16267",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.