NPIMap

Individual provider Active NPI

Pradip M Mehta, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Dayton, OH
National Provider Identifier
1639151079
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
35.123682 Issued in OH
Practice address
100 Elmwood Park Dr
Dayton, OH 45449-5402
Phone
(937) 384-0580
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.123682 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 35.123682 OH
Pain Medicine Physician 208VP0000X 35.123682 OH
Interventional Pain Medicine Physician 208VP0014X 35.123682 OH
Addiction Medicine (Internal Medicine) Physician 207RA0401X 35.123682 OH Primary

Addresses

Primary practice location

100 Elmwood Park Dr
Dayton, OH 45449-5402

Mailing address

100 Elmwood Park Dr
Dayton, OH 45449-5402
Phone (937) 384-0580

Other identifiers 1

IdentifierTypeStateIssuer
2840804MedicaidOH

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

LicenseStateTypeSpecialty
35.123682OHMDPain Medicine (Anesthesiology) Physician
ME50029FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Faculty Services Inc PastSince Aug 1, 2005 Accepting new patients
Recovery Works Holding Company LLC Past Accepting new patients
Fairview Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/recoveryworkshealingcenter/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1639151079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELMWOOD PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454495402",
            "telephone_number": "937-384-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELMWOOD PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454495402",
            "telephone_number": "937-384-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "PRADIP",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.123682",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35.123682",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OH",
            "license": "35.123682",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OH",
            "license": "35.123682",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.123682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2840804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.