Individual provider Active NPI

Sunil Mehta, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1699979823
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
61138 Issued in MN
Practice address
760 Westwood PLZ # 951759
UCLA Psych & Biobehavioral Sciences
Los Angeles, CA 90095
Phone
(310) 983-1428
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A108182 CA
Psychiatry Physician 2084P0800X 61138 MN Primary

Addresses

Primary practice location

760 Westwood PLZ # 951759
UCLA Psych & Biobehavioral Sciences
Los Angeles, CA 90095

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

760 Westwood Plz # 951759
UCLA Psych & Biobehavioral Sciences
Los Angeles, CA 90095-1759
Phone (310) 983-1428

Other practice location 2

760 Westwood Plz # 951759
UCLA Psych & Biobehavioral Sciences
Los Angeles, CA 90095
Phone (310) 983-1428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809002641 MN Practitioner - PsychiatryPractitioner - Pediatric Medicine 6507014099 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61138MNMDPsychiatry Physician
A108182CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Psychiatry CurrentSince Mar 27, 2023 Accepting new patients
Prairiecare LLC Psychiatry PastSince Mar 27, 2023 Accepting new patients

Locations

120 E Main St
Mankato, MN 56001
Phone (507) 322-5464

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

5255 Members Pkwy NW
Rochester, MN 55901
Phone (507) 218-3701

Organizations & group practices 2

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1699979823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ # 951759",
            "address_2": "UCLA PSYCH & BIOBEHAVIORAL SCIENCES",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-983-1428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Westwood Plz # 951759",
            "address_2": "UCLA Psych & Biobehavioral Sciences",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900951759",
            "country_code": "US",
            "telephone_number": "310-983-1428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Westwood Plz # 951759",
            "address_2": "UCLA Psych & Biobehavioral Sciences",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90095",
            "country_code": "US",
            "telephone_number": "310-983-1428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SUNIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A108182",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "61138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.