Individual provider Active NPI

Noopur Mehta, PA-C

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1417682931
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
460 N Elm St
Escondido, CA 92025-3002
Phone
(833) 867-4642
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

460 N Elm St
Escondido, CA 92025-3002

Mailing address

10413 Galena Canyon Rd
San Diego, CA 92127-4461
Phone (760) 688-8004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109003479 CA Practitioner - Physician Assistant 6103293816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100

728 E Valley Pkwy
Escondido, CA 92025-3052
Phone (760) 737-6900

855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61536CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Sep 19, 2022 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 19, 2022 Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

460 N Elm St
Escondido, CA 92025
Phone (760) 520-8100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1417682931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10413 GALENA CANYON RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921274461",
            "telephone_number": "760-688-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N ELM ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253002",
            "telephone_number": "833-867-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "NOOPUR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.