Organization Active NPI

Rajendra Mehta, MD, PC

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Jackson, MI
National Provider Identifier
1477168607
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
Legal business name
RAJENDRA MEHTA, MD, PC
Practice address
306 W Washington Ave Ste 102
Jackson, MI 49201-2141
Phone
(517) 744-5112
NPI assigned
Sep 14, 2020
Last updated
Dec 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Rejendra Mehta, MD
Title
Doctor
Phone
(517) 435-0260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X NU Primary

Addresses

Primary practice location

306 W Washington Ave Ste 102
Jackson, MI 49201-2141

Mailing address

306 W Washington Ave Ste 102
Jackson, MI 49201-2141
Phone (517) 744-5112

Other identifiers 1

IdentifierTypeStateIssuer
4301068733OtherMIMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028000965 MI Part B Supplier - Clinic/Group Practice 3577973833 Receives reassigned benefits from 6 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Locations

823 E Michigan Ave
#30
Jackson, MI 49201

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1477168607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-744-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-744-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJENDRA MEHTA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "REJENDRA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "517-435-0260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "4301068733",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.