NPIMap

Individual provider Active NPI

Kalyani Nilesh Mehta, MD

  • Nephrology Physician
  • Granada Hills, CA
National Provider Identifier
1699899724
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A89911 Issued in CA
Practice address
10605 Balboa Blvd
240
Granada Hills, CA 91344-6342
Phone
(818) 366-4626
Fax
(818) 366-4630
NPI assigned
Mar 16, 2007
Last updated
Mar 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A89911 CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
240
Granada Hills, CA 91344-6342

Mailing address

10605 Balboa Blvd
240
Granada Hills, CA 91344-6342
Phone (818) 366-4626

Other identifiers 1

IdentifierTypeStateIssuer
00A899110MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111121000129 CA Practitioner - NephrologyPractitioner - Internal Medicine 8628161643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Consultants Medical GroupGroup PAC ID 9335126010, 9 clinicians

Practice addresses (Care Compare)

23928 Lyons Ave
Suite 105
Newhall, CA 91321-2453
Phone (661) 254-0193

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89911CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Consultants Medical Group Nephrology CurrentSince Mar 27, 2013 Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Sinai Hospital of Greater Detroit Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
Harper-Hutzel Hospital Past Accepting new patients
Wayne State University School of Medicine Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Sinai Hospital of Greater Detroit Past Accepting new patients
VHS Huron Valley-Sinai Hospital Inc Past Accepting new patients

Locations

10605 Balboa Blvd
Ste 240
Granada Hills, CA 91344
Phone (818) 366-3935

23928 Lyons Ave
Ste 105
Newhall, CA 91321
Phone (661) 254-0193

23928 Lyons Ave
Ste 205
Newhall, CA 91321
Phone (661) 254-0193

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kmehta61400@direct.acumenmd.com

Organizations & group practices 12

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 6

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1699899724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "240",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-366-4626",
            "fax_number": "818-366-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "240",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-366-4626",
            "fax_number": "818-366-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KALYANI",
        "middle_name": "NILESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A89911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A899110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

Verify at the official NPI Registry.