Active NPI
Cynthia Lee Mehta, MD
- Dermatology Physician
- Sun Prairie, WI
National Provider Identifier
1467678219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 35613
- Practice address
- 3527 Swansee RDG
Sun Prairie, WI 53590-9487 - Phone
- (608) 318-0312
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 35613 | WI | Primary |
| Dermatology Physician | 207N00000X | G87738 | CA |
Addresses
Primary practice location
3527 Swansee RDG
Sun Prairie, WI 53590-9487
Mailing address
3527 Swansee Ridge
Sun Prairie, WI 53590
Phone (608) 318-0312
Other names 1
- Cindy Duimstra
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G87738 | CA | MD | Dermatology Physician |
| 35613 | WI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467678219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3527 SWANSEE RIDGE",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "53590",
"telephone_number": "608-318-0312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3527 SWANSEE RDG",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535909487",
"telephone_number": "608-318-0312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "CYNTHIA",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "35613",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G87738",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CINDY",
"last_name": "DUIMSTRA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.