Individual provider Active NPI

Khyati Pravin Mehta, MD

  • Pediatric Gastroenterology Physician
  • Loma Linda, CA
National Provider Identifier
1558490912
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD19347 Issued in ME
Practice address
25845 Barton Rd Ste 101
Loma Linda, CA 92354-5300
Phone
(909) 558-3904
Fax
(909) 558-3906
NPI assigned
Mar 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X A139765 CA
Pediatric Gastroenterology Physician 2080P0206X MD19347 ME Primary

Addresses

Primary practice location

25845 Barton Rd Ste 101
Loma Linda, CA 92354-5300

Mailing address

25845 Barton Rd Ste 101
Loma Linda, CA 92354-5300
Phone (909) 558-3904

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026001115 CA Practitioner - Pediatric Medicine 2668622945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A139765CAMDPediatric Gastroenterology Physician
MD19347MEMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 8, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 8, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 16, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Interoperability endpoints

  • Direct secure messaging: kmehta118006@direct.llu.edu

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1558490912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD STE 101",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923545300",
            "telephone_number": "909-558-3904",
            "fax_number": "909-558-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD STE 101",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923545300",
            "telephone_number": "909-558-3904",
            "fax_number": "909-558-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KHYATI",
        "middle_name": "PRAVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A139765",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "ME",
            "license": "MD19347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.