Individual provider Active NPI

Manish Mehta, MD

  • Vascular Surgery Physician
  • Latham, NY
National Provider Identifier
1376534602
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
205079 Issued in NY
Practice address
6 Wellness Way Ste G02
Latham, NY 12110-2135
Phone
(518) 782-3900
Fax
(518) 782-3844
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 205079 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste G02
Latham, NY 12110-2135

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
02164583MedicaidNY

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
I20040416001319 NY Practitioner - Vascular Surgery 9436143765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
New York Medical College, 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)

123 Quaker Rd
Suite 106
Queensbury, NY 12804-1714
Phone (518) 640-6752

Hospital & facility affiliations

  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
  • Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276
  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
98.76
Improvement activities
40
Cost
76.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal39
Leg revascularization (restoring blood flow)191
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Jul 1, 2015 Accepting new patients
Community Care Physicians, PC Vascular Surgery CurrentSince Apr 14, 2024 Accepting new patients
Community Care Physicians, PC Vascular Surgery Past Accepting new patients

Locations

47 New Scotland Ave
#113
Albany, NY 12208

47 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6060

47 New Scotland Ave
#157
Albany, NY 12208

2520 Riverfront Ctr
Amsterdam, NY 12010
Phone (518) 782-3900

6 Wellness Way
Ste G02
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

713 Troy Schenectady Rd
Ste 125
Latham, NY 12110
Phone (518) 782-3900

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

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

6 Wellness Way
Ste G04
Latham, NY 12110
Phone (518) 785-5884

123 Quaker Rd
Ste 106
Queensbury, NY 12804
Phone (518) 640-6752

123 Quaker Rd
Ste 104
Queensbury, NY 12804
Phone (518) 782-3799

123 Quaker Rd
#106
Queensbury, NY 12804
Phone (518) 640-6752

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

Organizations & group practices 3

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.

Hospital & facility affiliations 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1376534602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "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": "6 WELLNESS WAY STE G02",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102135",
            "telephone_number": "518-782-3900",
            "fax_number": "518-782-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MANISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "205079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.