Elisabeth L Mehta, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036105049 Issued in IL

Practice address

101 S Washington
Suite 122
Park Ridge, IL 60068

Phone

(847) 692-6628

Fax

(847) 692-6891

NPI assigned

Jul 5, 2006

Last updated

Dec 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: elisabeth.mehta@prpp.eclinicaldirectplus.com
• Direct secure messaging: emehta252298@direct.myadvocateaurora.org
• FHIR API: https://fhir4.healow.com/fhir/r4/IGFFCA/Endpoint/IGFFCA

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.

• Park Ridge Pediatrics PC

  • Pediatrics Physician
  • Park Ridge, IL
  • NPI 1518979327
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1336170554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON",
            "address_2": "SUITE 122",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-692-6628",
            "fax_number": "847-692-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON",
            "address_2": "SUITE 122",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-692-6628",
            "fax_number": "847-692-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "ELISABETH",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036105049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "101 S Washington",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emehta252298@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 S Washington",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bridget Melody

• Pediatrics Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.