Praveen S Mehta, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

215909 Issued in MA

Practice address

4500 S Lancaster Rd
Amb Care 11C
Dallas, TX 75216-7167

Phone

(214) 857-1911

NPI assigned

Apr 25, 2006

Last updated

Nov 2, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Genesee Valley Group Health Association

  dba Lifetime Health Medical Group

  • Clinic Pharmacy
  • Rochester, NY
  • NPI 1962591875
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225584000000",
    "number": "1407812738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "AMB CARE 11C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "AMB CARE 11C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "PRAVEEN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "215909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187178",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manan M Mehta, MD
• Megha S Mehta, M.D.
• Neha Harish Mehta, PA
• Parthiv Mehta
• Poonam Mehta, OT
• Prayag Mehta, M.D.
• Radhika Mehta
• Smruti Mehta, RPH
• Sonya Mehta, CCC-SLP
• Sumita R Mehta, MD

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2008; 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.