Individual provider Active NPI

Jay Mahendrakumar Mehta

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1184300238
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15688 Issued in NC
Practice address
2157 Main St
Buffalo, NY 14214-2692
Phone
(716) 862-1000
NPI assigned
Jun 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15688 NC Primary
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X 030161 NY

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2692

Mailing address

2605 Harlem Rd
Cheektowaga, NY 14225-4018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230828002495 NY Practitioner - Physician Assistant 6507229358 Reassigns benefits to 1 organization
I20251219002015 NC Practitioner - Physician Assistant 6507229358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

104 Huffman Mill Rd
Burlington, NC 27215-5113
Phone (336) 506-1720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030161NYMDMassage Therapist
0010-15688NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fastmed P.C. CurrentSince Oct 20, 2025 Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Locations

104 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 506-1720

7010 NC Highway 751
Durham, NC 27707
Phone (919) 313-3900

1589 Skeet Club Rd
Ste 155
High Point, NC 27265
Phone (336) 899-2160

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1184300238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142692",
            "telephone_number": "716-862-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "JAY",
        "middle_name": "MAHENDRAKUMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15688",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.