NPIMap

Individual provider Active NPI

Mitali Mehta, M.D.

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1366977647
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
86023 Issued in GA
Practice address
171 Ashley Ave
Charleston, SC 29425-3838
Phone
(706) 631-1139
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 86023 GA Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-3838

Mailing address

2170 Annie Laura LN
Mount Pleasant, SC 29466-8800
Phone (706) 631-1139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX, OH, SC, AZ, CA6 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20200911001278 GA Practitioner - Emergency Medicine 6406274174 Reassigns benefits to 2 organizations
I20230228002925 TX Practitioner - General Practice 6406274174 Reassigns benefits to 1 organization
I20230502003313 OH Practitioner - Emergency Medicine 6406274174 Reassigns benefits to 1 organization
I20230913000934 SC Practitioner - Emergency Medicine 6406274174 Reassigns benefits to 2 organizations
I20241024001769 AZ Practitioner - General Practice 6406274174 Reassigns benefits to 1 organization
I20260520004426 CA Practitioner - Emergency Medicine 6406274174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86023GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cmdpn Medical Group of Washington P C Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Dec 29, 2025 Accepting new patients
Cirrusmd Medical Group of Delaware, P.a. Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 13, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol Family Medicine CurrentSince Jul 13, 2023 Accepting new patients

Locations

11201 N Tatum Blvd
Ste 300
Phoenix, AZ 85028
Phone (480) 900-3556

3000 Lawrence St
#101
Denver, CO 80205
Phone (916) 215-4554

3513 Brighton Blvd
Ste 230
Denver, CO 80216
Phone (303) 653-7720

3000 Lawrence St
Ste 101
Denver, CO 80205

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1985 Henderson Rd
Columbus, OH 43220
Phone (206) 495-0724

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: mitali.mehta.p1@direct.scdc.nextgenshare.com
  • Direct secure messaging: mmehta431327@direct.musc.edu

Organizations & group practices 8

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1366977647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 ANNIE LAURA LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668800",
            "telephone_number": "706-631-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294253838",
            "telephone_number": "706-631-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MITALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "86023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.