Raj Mehta, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

137744 Issued in NY

Practice address

170 West Ave
Brockport, NY 14420-1227

Phone

(585) 368-4050

Fax

(585) 723-6705

NPI assigned

Jul 24, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment NPD
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1306868633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANAL LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146265107",
            "telephone_number": "585-368-4050",
            "fax_number": "585-723-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201227",
            "telephone_number": "585-368-4050",
            "fax_number": "585-723-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "137744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00763671",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason McClung, MD
• Robert McClurg, FNP
• Patricia M McKenna, LMT
• Erwin McKenzie
• Kyle McNeil, DPT
• Jenna Menear
• Metro Footcare Associates
• Metro Footcare Associates
• Brenda Lynn Michael
• Christina Middleton, PT

• Internal Medicine Physician in Brockport, NY
• Providers in Brockport, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.