Individual provider Active NPI

Tejas R Mehta, M.D.

  • Pediatric Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1225213804
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
057547 Issued in GA
Practice address
5445 Meridian Marks Rd
Suite 490
Atlanta, GA 30342-4763
Phone
(404) 843-6320
Fax
(404) 843-6321
NPI assigned
Jan 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 057547 GA Primary
Pediatric Gastroenterology Physician 2080P0206X ME104551 FL

Addresses

Primary practice location

5445 Meridian Marks Rd
Suite 490
Atlanta, GA 30342-4763

Mailing address

5445 Meridian Marks Rd
Suite 490
Atlanta, GA 30342-4763
Phone (404) 843-6320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20150408001109 GA Practitioner - Gastroenterology 1254478639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
057547GAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aga, LLC CurrentSince Nov 1, 2014 Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients

Locations

2020 Cumming Hwy
#102
Canton, GA 30115
Phone (678) 593-1295

2660 Satellite Blvd
Duluth, GA 30096
Phone (404) 785-8330

1260 Highway 54 W
Ste 103
Fayetteville, GA 30214
Phone (770) 486-7000

301 Philip Blvd
Ste A
Lawrenceville, GA 30046
Phone (770) 822-5560

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

4800 Olde Towne Pkwy
Ste 370
Marietta, GA 30068
Phone (404) 252-9307

488 Kennesaw Ave NW
Ste 150
Marietta, GA 30060
Phone (770) 427-3075

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

2401 Newnan Crossing Blvd E
Ste 110
Newnan, GA 30265
Phone (678) 631-4610

5445 Meridian Mark Rd
Ste 490
Sandy Springs, GA 30342
Phone (404) 252-9307

5671 Peachtree Dunwoody Rd
Ste 511
Sandy Springs, GA 30342

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1225213804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD",
            "address_2": "SUITE 490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424763",
            "telephone_number": "404-843-6320",
            "fax_number": "404-843-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD",
            "address_2": "SUITE 490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424763",
            "telephone_number": "404-843-6320",
            "fax_number": "404-843-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "TEJAS",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "GA",
            "license": "057547",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME104551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.