NPIMap

Individual provider Active NPI

Nimish Mehta, MD

  • Emergency Medicine Physician
  • Charleston, WV
National Provider Identifier
1649257916
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20051 Issued in WV
Practice address
800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone
(304) 388-2550
NPI assigned
Dec 28, 2005
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20051 WV Primary
Pediatrics Physician 208000000X 20051 WV

Addresses

Primary practice location

800 Pennsylvania Ave
Charleston, WV 25302-3351

Mailing address

3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304-1228
Phone (304) 388-1724

Other identifiers 3

IdentifierTypeStateIssuer
1803190000MedicaidWV
1057343OtherWVWV DWC
001718074OtherWVWV BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20060314000387 WV Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8729095963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
JC Edwards School of Medicine, Marshall University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20051WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Dec 1, 2016 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 203
Charleston, WV 25304
Phone (304) 345-8820

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1649257916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "STE 203",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041228",
            "telephone_number": "304-388-1724",
            "fax_number": "304-388-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-388-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "NIMISH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "20051",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "20051",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1803190000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1057343",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BCBS",
            "identifier": "001718074",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.