Individual provider Active NPI

Vijay A. Mehta, MD

  • Cardiovascular Disease Physician
  • Elkhart, IN
National Provider Identifier
1801921325
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01063868A Issued in IN
Practice address
500 Arcade Ave Ste 400
Suite 400
Elkhart, IN 46514-2487
Phone
(574) 522-2284
Fax
(574) 522-3952
NPI assigned
Feb 23, 2007
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01063868A IN
Cardiovascular Disease Physician 207RC0000X 01063868A IN Primary
Nuclear Cardiology Physician 207UN0901X 01063868A IN

Addresses

Primary practice location

500 Arcade Ave Ste 400
Suite 400
Elkhart, IN 46514-2487

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

3220 Beacon Pkwy Ste 200
Granger, IN 46530-7196
Phone (574) 999-8838

Other identifiers 1

IdentifierTypeStateIssuer
200860370MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MEHTA@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070626000604 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5092814491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

500 Arcade Ave
Suite 400
Elkhart, IN 46514-2487
Phone (574) 522-2284

600 E Blvd
Elkhart, IN 46514-2483

600 E Blvd 4TH FL Hospitalists
BMG Hospital Specialties
Elkhart, IN 46514-2483
Phone (574) 647-3050

6913 N Main St
Granger, IN 46530-8039

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063868AINMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Cardiovascular Disease Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 1, 2014 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

500 Arcade Ave
Ste 400
Elkhart, IN 46514
Phone (574) 522-2284

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

600 East Blvd
#3
Elkhart, IN 46514
Phone (574) 523-2750

3220 Beacon Pkwy
Ste 200
Granger, IN 46530
Phone (574) 647-8788

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Interoperability endpoints

  • Direct secure messaging: mehta@mybeacon.cernerdirect.com

Organizations & group practices 3

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 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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1801921325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE STE 400",
            "address_2": "SUITE 400",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142487",
            "telephone_number": "574-522-2284",
            "fax_number": "574-522-3952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 Beacon Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465307196",
            "country_code": "US",
            "telephone_number": "574-999-8838",
            "fax_number": "574-999-8839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "VIJAY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01063868A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01063868A",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "IN",
            "license": "01063868A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200860370",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MEHTA@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "500 Arcade Ave",
            "address_2": "Suite 400",
            "city": "Elkhart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465142477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.