NPIMap

Individual provider Active NPI

Robert L Mahanti, M.D.

  • Ophthalmology Physician
  • Flagstaff, AZ
National Provider Identifier
1730146499
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20847 Issued in AZ
Practice address
900 N San Francisco St
Flagstaff, AZ 86001-3236
Phone
(928) 779-7000
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 20847 AZ Primary

Addresses

Primary practice location

900 N San Francisco St
Flagstaff, AZ 86001-3236

Mailing address

PO Box 31012
Flagstaff, AZ 86003-1012
Phone (928) 779-7000

Other identifiers 7

IdentifierTypeStateIssuer
AZ0380480OtherAZBLUE CROSS BLUE SHIELD
1659445062OtherGROUP NPI
180022943OtherMEDICARE RAILROAD
110510OtherAPIPA
DG6643OtherMEDICARE RAILROAD GROUP
110510MedicaidAZ
290066OtherMEDICAID GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040513001412 TX Practitioner - Ophthalmology 2466442256 Reassigns benefits to 1 organization
I20050609001181 AZ Practitioner - Ophthalmology 2466442256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Eye AssociatesGroup PAC ID 5991748212, 2 clinicians
The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

900 N San Francisco St
Flagstaff, AZ 86001-3236
Phone (928) 779-7000

Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082

PO Box
Suite 649
Fort Defiance, AZ 86504-0649

Hospital & facility affiliations

  • White Mountain Regional Medical Center Hospital, Springerville, AZ, CCN 031315
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
  • Sage Memorial Hospital Hospital, Ganado, AZ, CCN 031309

Merit-based Incentive Payment System (MIPS)

Final score
19.54 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
65.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery563

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Eye Associates Ophthalmology CurrentSince Apr 9, 1997 Accepting new patients
Northern Arizona Eye Associates Current Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Mar 28, 2010 Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
Western Medical Eye Center Past Accepting new patients

Locations

900 N San Francisco St
#2
Flagstaff, AZ 86001
Phone (520) 779-7000

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

900 N San Francisco St
Flagstaff, AZ 86001
Phone 928774032219

Interoperability endpoints

  • Direct secure messaging: rob.mahanti@mahanti.direct.eyemdemr.com

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1730146499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31012",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860031012",
            "telephone_number": "928-779-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N SAN FRANCISCO ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013236",
            "telephone_number": "928-779-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHANTI",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "20847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0380480",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1659445062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "180022943",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APIPA",
            "identifier": "110510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "DG6643",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110510",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "290066",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.