Individual provider Active NPI

Abhishek Mehta, MBBS

  • Pediatrics Physician
  • Lompoc, CA
National Provider Identifier
1255691341
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A147857 Issued in CA
Practice address
1225 N H St
Lompoc, CA 93436
Phone
(805) 737-8760
Fax
(805) 681-1768
NPI assigned
May 22, 2012
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A147857 CA Primary

Addresses

Primary practice location

1225 N H St
Lompoc, CA 93436

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 737-8760

Other practice location 1

3901 Rainbow Blvd # MS 4004
Kansas City, KS 66103-2937
Phone (913) 588-6917

Other identifiers 1

IdentifierTypeStateIssuer
A147857OtherCASTATE LICENSE NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190325002871 CA Practitioner - Pediatric Medicine 3476850538 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A147857CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lompoc Valley Medical Center Pediatrics CurrentSince Jan 15, 2019 Accepting new patients

Locations

1225 N H St
Lompoc, CA 93436
Phone (805) 737-8700

136 N 3rd St
Lompoc, CA 93436
Phone (805) 736-1253

1515 E Ocean Ave
Lompoc, CA 93436
Phone (805) 737-3300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: abhishek.mehta@lvmc.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1255691341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-737-8760",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N H ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "93436",
            "telephone_number": "805-737-8760",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd # MS 4004",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661032937",
            "country_code": "US",
            "telephone_number": "913-588-6917",
            "fax_number": "913-588-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "ABHISHEK",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A147857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "A147857",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.