Active NPI
Meena Desai, MD
- Internal Medicine Physician
- Peckville, PA
National Provider Identifier
1629185848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD027269-E
- Practice address
- 29 Depot Street
Peckville, PA 18452-2323 - Phone
- (570) 383-7233
- Fax
- (570) 489-2802
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD027269-E | PA | Primary |
| Pulmonary Disease Physician | 207RP1001X | MD027269-E | PA |
Addresses
Primary practice location
29 Depot Street
Peckville, PA 18452-2323
Mailing address
29 Depot Street
Peckville, PA 18452-2323
Phone (570) 383-7233
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009377430004 | Medicaid | PA | |
| 900097656 | Other | PA | RAILROAD MEDICARE |
| 443363 | Other | PA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD027269-E | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lackawanna Medical Group PC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Scranton, PA
- NPI 1770650962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264118400000",
"number": "1629185848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 DEPOT STREET",
"city": "PECKVILLE",
"state": "PA",
"postal_code": "184522323",
"telephone_number": "570-383-7233",
"fax_number": "570-489-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 DEPOT STREET",
"city": "PECKVILLE",
"state": "PA",
"postal_code": "184522323",
"telephone_number": "570-383-7233",
"fax_number": "570-489-2802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "MEENA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2010-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD027269-E",
"primary": true
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "PA",
"license": "MD027269-E",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009377430004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "900097656",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "443363",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peckville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.