Individual provider Active NPI

Beulah Puthuparampil-Mehta, DO

  • Pediatrics Physician
  • Clifton Park, NY
National Provider Identifier
1346324282
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202386-1 Issued in NY
Practice address
942A Route 146
Clifton Park, NY 12065-3614
Phone
(518) 371-8000
Fax
(518) 371-5338
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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 202386-1 NY Primary

Addresses

Primary practice location

942A Route 146
Clifton Park, NY 12065-3614

Mailing address

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
02187048MedicaidNY

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
I20110409000026 NY Practitioner - Pediatric Medicine 8123202546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

711 Troy Schenectady Rd
Latham, NY 12110-2461

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202386-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Pediatrics CurrentSince Jan 19, 2011 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

942A Route 146
Clifton Park, NY 12065
Phone (518) 371-8000

1783 Route 9
Ste 101
Halfmoon, NY 12065
Phone (518) 881-1091

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 201
Latham, NY 12110

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1346324282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942A ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653614",
            "telephone_number": "518-371-8000",
            "fax_number": "518-371-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHUPARAMPIL-MEHTA",
        "first_name": "BEULAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "202386-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187048",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.