Organization Active NPI

Premier Hematology & Tele-Oncology Center, PLLC

  • Hematology & Oncology Physician
  • Cary, NC
National Provider Identifier
1548615347
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2010-00625 Issued in NC
Legal business name
PREMIER HEMATOLOGY & TELE-ONCOLOGY CENTER, PLLC
Practice address
550 New Waverly PL Ste 120
Cary, NC 27518-7412
Phone
(919) 642-3738
Fax
(919) 585-1554
NPI assigned
Apr 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Authorized official

Name
Dr. Amit R Mehta, M.DNPI 1740460377
Title
President
Phone
(919) 642-3738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X 2010-00625 NC Primary

Addresses

Primary practice location

550 New Waverly PL Ste 120
Cary, NC 27518-7412

Mailing address

550 New Waverly PL
Suite 120
Cary, NC 27518-7412
Phone (919) 642-3738

Other identifiers 1

IdentifierTypeStateIssuer
5914372MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160831001597 NC Part B Supplier - Clinic/Group Practice 3072809037 Receives reassigned benefits from 1 practitioner
Practice locations: Cary, NC; Durham, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1548615347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 NEW WAVERLY PL",
            "address_2": "SUITE 120",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187412",
            "telephone_number": "919-642-3738",
            "fax_number": "919-585-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 NEW WAVERLY PL STE 120",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187412",
            "telephone_number": "919-642-3738",
            "fax_number": "919-585-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEMATOLOGY & TELE-ONCOLOGY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2018-03-01",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "AMIT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-642-3738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2010-00625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5914372",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.