Individual provider Active NPI

Rajendra H Mehta, MD

  • Cardiovascular Disease Physician
  • Jackson, MI
National Provider Identifier
1770549099
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
RM068733 Issued in MI
Practice address
306 W Washington Ave Ste 102
Jackson, MI 49201-2141
Phone
(517) 435-0260
Fax
(517) 435-0261
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X RM068733 MI Primary

Addresses

Primary practice location

306 W Washington Ave Ste 102
Jackson, MI 49201-2141

Mailing address

306 W Washington Ave Ste 102
Jackson, MI 49201-2141
Phone (517) 435-0260

Other identifiers 1

IdentifierTypeStateIssuer
4769501MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040401001179 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2860484573 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians
Rajendra Mehta, MD, PCGroup PAC ID 3577973833, 5 clinicians

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800

306 W Washington Ave
Suite 102
Jackson, MI 49201-2141
Phone (517) 435-0260

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RM068733MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Rajendra Mehta, MD, PC CurrentSince Aug 15, 2020 Accepting new patients
Jackson OB-GYN PLC CurrentSince Aug 15, 2020 Accepting new patients
Jackson Cardiology & Associates Cardiovascular Disease CurrentSince Jul 1, 2004 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 30, 2017 Accepting new patients
Jackson Cardiology Consultants PLLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

306 W Washington Ave
Ste 102
Jackson, MI 49201
Phone (517) 435-0260

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

214 N West Ave
Jackson, MI 49201
Phone (517) 784-9189

1701 Lake Lansing Rd
Ste 100
Lansing, MI 48912
Phone (517) 485-9676

Interoperability endpoints

  • Direct secure messaging: rmehta444313@direct.hfhs.org

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 2

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1770549099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-435-0260",
            "fax_number": "517-435-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-435-0260",
            "fax_number": "517-435-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RAJENDRA",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "RM068733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4769501",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.