Individual provider Active NPI

Nilesh D Mehta, MD

  • Medical Oncology Physician
  • Goodyear, AZ
National Provider Identifier
1578502159
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
64889 Issued in AZ
Practice address
14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone
(800) 322-9183
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036.077916 IL
Medical Oncology Physician 207RX0202X 64889 AZ Primary

Addresses

Primary practice location

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007

Mailing address

6897 Paysphere Circle
Chicago, IL 60674-0001
Phone (800) 294-8333

Other identifiers 1

IdentifierTypeStateIssuer
036077916MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100702000007 IL Practitioner - Hematology/Oncology 5991897381 Reassigns benefits to 1 organization
I20240909002039 AZ Practitioner - Medical Oncology 5991897381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians

Practice addresses (Care Compare)

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.52 of 100Reported as group
Quality
66.08
Promoting interoperability
100
Improvement activities
40
Cost
58.3

Merit-based Incentive Payment System (MIPS)

Final score
75.05 of 100Reported as group
Quality
68.45
Promoting interoperability
100
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64889AZMDMedical Oncology Physician
036.077916ILMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waukegan Clinic Corp Family Medicine Current Accepting new patients
City of Hope Medical Group of Arizona LLC Medical Oncology CurrentSince Oct 1, 2024 Accepting new patients
Oncology Hematology Associates of Northern Illinois, LTD CurrentSince Oct 1, 2013 Accepting new patients
Ctca Physicians Group of Illinois, Inc Medical Oncology Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

202 S Greenleaf St
Ste E
Gurnee, IL 60031
Phone (800) 322-9183

200 S Greenleaf St
Ste L
Gurnee, IL 60031
Phone (847) 360-7888

Interoperability endpoints

  • Direct secure messaging: nmehta147774@cityofhope.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1578502159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6897 PAYSPHERE CIRCLE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740001",
            "telephone_number": "800-294-8333",
            "fax_number": "847-746-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "800-322-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "NILESH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036.077916",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AZ",
            "license": "64889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077916",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.