Supal Mehta, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0100509 Issued in MD

Practice address

1775 Ballard Rd
Park Ridge, IL 60068-1005

Phone

(847) 318-6020

NPI assigned

Apr 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hospitalist

Education

Loyola University of Chicago, Stritch School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smehta1238648@direct.hopkinsmedicine.org

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868
  Medicare reassignment Care Compare group NPD
• Johns Hopkins Community Physicians

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1124629837
  NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806

  Internal Medicine

  NPD
• Howard County General Hospital, Inc,

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  NPD (past)

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

• Howard County General Hospital, Inc,

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  Care Compare affiliation

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1578142014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 BALLARD RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681005",
            "telephone_number": "847-318-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5755 Cedar Ln",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210442912",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SUPAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0100509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meersman Acupuncture and Herbal Medicine PLLC
• Megan Brady Counseling, PLLC
• Donna Mehdiyar, DO
• Elisabeth L Mehta, M.D.
• Shilpa P. Mehta, M.D.
• Marwa Mekki, MD
• Lisa J Melnick
• Bridget Melody
• Michal Ora Mendelsberg
• Leticia Mendez, APN

• Internal Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.