Individual provider Active NPI

Davendra Mehta, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Richmond Hill, NY
National Provider Identifier
1326084971
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
191259 Issued in NY
Practice address
117-10 Hillside Avenue
Richmond Hill, NY 11419
Phone
(718) 297-0440
Fax
(718) 297-0442
NPI assigned
Jun 21, 2006
Last updated
Apr 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 191259 NY
Clinical Cardiac Electrophysiology Physician 207RC0001X 191259 NY Primary

Addresses

Primary practice location

117-10 Hillside Avenue
Richmond Hill, NY 11419

Mailing address

1 Gustave L Levy PL
Box 1030
New York, NY 10029-6500
Phone (212) 241-7272

Other identifiers 1

IdentifierTypeStateIssuer
01424148MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040908001005 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - General PracticePractitioner - Cardiac Electrophysiology 5193791408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3830 Parsons Blvd
Suite 1a
Flushing, NY 11354-5841
Phone (718) 762-3240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2012 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2012 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

3830 Parsons Blvd
Ste 1A
Flushing, NY 11354
Phone (310) 634-5702

3743 91st St
Jackson Heights, NY 11372
Phone (718) 565-5554

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

5 E 98th St
Fl 3
New York, NY 10029
Phone (212) 241-5170

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10114 Liberty Ave
Ozone Park, NY 11417
Phone (718) 487-3330

11710 Hillside Ave
Richmond Hill, NY 11418
Phone (718) 297-0440

341 Central Park Ave
Scarsdale, NY 10583
Phone (718) 676-5309

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 9

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1326084971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1030",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117-10 HILLSIDE AVENUE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "11419",
            "telephone_number": "718-297-0440",
            "fax_number": "718-297-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "DAVENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "191259",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NY",
            "license": "191259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01424148",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.