NPIMap

Individual provider Active NPI

Indrajeet Mahata, M.D

  • Clinical Cardiac Electrophysiology Physician
  • Springfield, MO
National Provider Identifier
1619225208
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
2020013458 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-3911
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125060970 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 2020013458 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200727003061 MO Practitioner - Cardiac Electrophysiology 2466702469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Mercy Hospital Lebanon Hospital, Lebanon, MO, CCN 260059
  • Mercy Hospital Aurora Hospital, Aurora, MO, CCN 261316
  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
  • Ozarks Healthcare Hospital, West Plains, MO, CCN 260078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125060970ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 1, 2020 Accepting new patients
Mercy Clinic Springfield Communities Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
University of Illinois Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

1235 E Cherokee St
Ste 2D2K
Springfield, MO 65804

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Ste 2D
Springfield, MO 65804

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Interoperability endpoints

  • Direct secure messaging: imahata1057086@directc.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1619225208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHATA",
        "first_name": "INDRAJEET",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125060970",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MO",
            "license": "2020013458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.