NPIMap

Individual provider Active NPI

Vivek Mehta, MD

  • Gastroenterology Physician
  • Urbana, IL
National Provider Identifier
1568438760
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036088515 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2529
Phone
(217) 383-3610
Fax
(217) 326-2704
NPI assigned
Feb 27, 2006
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036088515 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2529

Mailing address

611 W Park St
Fapc
Urbana, IL 61801

Other identifiers 1

IdentifierTypeStateIssuer
036088515MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000996 IL Practitioner - Gastroenterology 9133020811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
George N Atia MD SCGroup PAC ID 2961506670, 12 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

200 Fox Glen CT
Barrington, IL 60010-1809
Phone (847) 382-7165

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy237
Upper gastrointestinal (GI) endoscopy for acid reflux513

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group Gastroenterology CurrentSince Apr 20, 2020 Accepting new patients
George N Atia, M.D., S.C. Gastroenterology CurrentSince Jul 1, 2020 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Aghapy Surgical Center SC Past Accepting new patients
Freeport Memorial Hospital PastSince Jun 16, 2024 Accepting new patients
Windy City Anesthesia PC PastSince Jul 1, 2020 Accepting new patients

Locations

200 Fox Gln
Barrington, IL 60010
Phone (847) 382-7165

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

5744 N Broadway St
Chicago, IL 60660
Phone (312) 335-0180

5744 N Broadway St
Fl 2
Chicago, IL 60660

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

1710 N Randall Rd
Ste 280
Elgin, IL 60123
Phone (847) 931-7550

22285 N Pepper Rd
Ste 409
Lake Barrington, IL 60010
Phone (847) 382-7165

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1824 Wilmette Ave
Wilmette, IL 60091
Phone (847) 256-3355

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1568438760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-3610",
            "fax_number": "217-326-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "VIVEK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036088515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.