Individual provider Active NPI

Ruby Mehta, MD

  • Pediatric Gastroenterology Physician
  • Washington, DC
National Provider Identifier
1497933832
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD043649 Issued in DC
Practice address
4200 Wisconsin Ave NW Ste 2
Washington, DC 20016-2143
Phone
(202) 243-3558
Fax
(877) 680-5504
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 4301089849 MI
Pediatric Transplant Hepatology Physician 2080T0004X 4696 GA
Pediatric Gastroenterology Physician 2080P0206X MD043649 DC Primary

Addresses

Primary practice location

4200 Wisconsin Ave NW Ste 2
Washington, DC 20016-2143

Mailing address

4200 Wisconsin Ave NW Ste 2
Washington, DC 20016-2143
Phone (202) 243-3558

Other practice location 1

4200 Wisconsin Ave NW Ste 2
Washington, DC 20016-2143
Phone (202) 243-3558

Other practice location 2

50 N Dunlap St
Memphis, TN 38103-2800
Phone (901) 287-6221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20171218002559 DC Practitioner - Pediatric Medicine 8022284694 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD043649DCMDPediatric Gastroenterology Physician
4301089849MIMDPediatric Gastroenterology Physician
4696GAMDPediatric Transplant Hepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MGMC, LLC CurrentSince Oct 14, 2017 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 14, 2017 Accepting new patients

Locations

4200 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 243-3400

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4200 Wisconsin Ave NW
Ste 2
Washington, DC 20016
Phone (202) 243-3558

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

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.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1497933832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162143",
            "telephone_number": "202-243-3558",
            "fax_number": "877-680-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162143",
            "telephone_number": "202-243-3558",
            "fax_number": "877-680-5504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Wisconsin Ave NW Ste 2",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200162143",
            "country_code": "US",
            "telephone_number": "202-243-3558",
            "fax_number": "877-680-5504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 N Dunlap St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032800",
            "country_code": "US",
            "telephone_number": "901-287-6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RUBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301089849",
            "primary": false
        },
        {
            "code": "2080T0004X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Transplant Hepatology",
            "state": "GA",
            "license": "4696",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "DC",
            "license": "MD043649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.