Organization Active NPI

Mehan Ophthalmology, Inc.

  • Ophthalmology Physician
  • Dayton, OH
National Provider Identifier
1750523874
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
093450O Issued in OH
Legal business name
MEHAN OPHTHALMOLOGY, INC.
Practice address
1020 Woodman Dr
Suite 200
Dayton, OH 45432-1446
Phone
(937) 258-4570
Fax
(937) 258-4573
NPI assigned
Apr 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Authorized official

Name
Dr. Maneesh Kumar Mehan, M.D.NPI 1386751949
Title
President
Phone
(937) 258-4570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 093450O OH Primary

Addresses

Primary practice location

1020 Woodman Dr
Suite 200
Dayton, OH 45432-1446

Mailing address

1020 Woodman Dr
Suite 200
Dayton, OH 45432-1446
Phone (937) 258-4570

Other identifiers 1

IdentifierTypeStateIssuer
2983786MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000109 OH Part B Supplier - Clinic/Group Practice 6709930233 Receives reassigned benefits from 2 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

1020 Woodman Dr
Ste 200
Dayton, OH 45432
Phone (937) 258-4570

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1750523874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321446",
            "telephone_number": "937-258-4570",
            "fax_number": "937-258-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321446",
            "telephone_number": "937-258-4570",
            "fax_number": "937-258-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHAN OPHTHALMOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "MEHAN",
        "authorized_official_first_name": "MANEESH",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-258-4570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "093450O",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2983786",
            "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 Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.