Mansi Sharadkumar Mehta

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704327956 Issued in MI

Practice address

705 S Main St
Plymouth, MI 48170-2089

Phone

(734) 454-3560

Fax

(832) 324-6751

NPI assigned

Aug 29, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Toledo College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mansi.mehta.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Plymouth, MI
  • NPI 1306616735

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Theory of Everything LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Farmington Hills, MI
  • NPI 1467234872

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Hles of Ohio, Inc.

  • Emergency Medicine Physician
  • Wauseon, OH
  • NPI 1679806301

  Multi-Specialty

  Medicare reassignment NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  MI, Multi-Specialty

  Medicare reassignment NPD
• Hles of Ohio Inc

  • Emergency Medicine Physician
  • East Liverpool, OH
  • NPI 1487380770

  Multi-Specialty

  NPD
• Hles of Ohio Inc

  • Emergency Medicine Physician
  • Coshocton, OH
  • NPI 1508301623

  Multi-Specialty

  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1609393735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37875 W 12 MILE RD STE 208",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313053",
            "telephone_number": "734-251-2662",
            "fax_number": "832-324-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702089",
            "telephone_number": "734-454-3560",
            "fax_number": "832-324-6751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37875 W 12 Mile Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483313053",
            "country_code": "US",
            "telephone_number": "734-251-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MANSI",
        "middle_name": "SHARADKUMAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021452",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704327956",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.021452",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704327956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephen Melonas

• Psychiatric/Mental Health Nurse Practitioner in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.