Individual provider Active NPI

Ajeet Singh Mehta, M.D.

  • Diagnostic Radiology Physician
  • Lisle, IL
National Provider Identifier
1811254592
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD472494 Issued in PA
Practice address
430 Warrenville Rd Ste 110
Lisle, IL 60532-1348
Phone
(630) 946-2020
NPI assigned
Apr 18, 2012
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neuroradiology Physician 2085N0700X 036-152359 IL
Neuroradiology Physician 2085N0700X MD472494 PA
Diagnostic Radiology Physician 2085R0202X MD472494 PA Primary
Diagnostic Radiology Physician 2085R0202X 036152359 IL
Diagnostic Radiology Physician 2085R0202X 080909 GA

Addresses

Primary practice location

430 Warrenville Rd Ste 110
Lisle, IL 60532-1348

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

401 Liberty Ave Ste 2000
Pittsburgh, PA 15222-1029
Phone (412) 230-8200

Other practice location 2

110 Irving St NW
Department of Internal Medicine
Washington, DC 20010-3017
Phone (202) 877-8278

Other practice location 3

790 Church St NE Ste 400
Marietta, GA 30060-8957
Phone (678) 239-0420

Other identifiers 1

IdentifierTypeStateIssuer
036152359MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amehta209749@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IL, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181022001996 GA Practitioner - Diagnostic Radiology 1052614211
I20200518002787 IL Practitioner - Diagnostic Radiology 1052614211 Reassigns benefits to 5 organizations
I20240311000598 IN Practitioner - Diagnostic Radiology 1052614211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Pittsburgh School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians
Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

1118 Hampshire St
Quincy, IL 62301-3027
Phone (217) 222-6550

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

861 W Roscoe St
Unit 3
Chicago, IL 60657-2303
Phone (832) 422-9562

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-152359ILMDNeuroradiology Physician
MD472494PAMDNeuroradiology Physician
036152359ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 17, 2025 Accepting new patients
The South Bend Clinic LLC CurrentSince Feb 20, 2024 Accepting new patients
The South Bend Clinic, LLC CurrentSince Feb 20, 2024 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 1, 2020 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 1, 2020 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 17, 2025 Accepting new patients
Diagnostic Systems Inc Diagnostic Radiology PastSince Jan 1, 2019 Accepting new patients
Synergy Radiology, LLC PastSince Jul 21, 2024 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Warrenville Rd
Ste 110
Lisle, IL 60532
Phone (630) 946-2020

430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

1118 Hampshire St
Quincy, IL 62301

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

301 E Day Rd
Mishawaka, IN 46545
Phone (574) 204-7300

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

471 E Broad St
Ste 1400
Columbus, OH 43215
Phone (614) 221-9241

1404 E 2nd St
Defiance, OH 43512
Phone (567) 368-1008

550 Mirabeau St
Greenfield, OH 45123
Phone (937) 672-4128

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

1932 Niles Cortland Rd NE
Ste X
Warren, OH 44484
Phone (330) 306-5371

100 Dawn Ln
Waverly, OH 45690
Phone (740) 947-2186

1430 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2705

Interoperability endpoints

  • Direct secure messaging: amehta209749@dulyhealthandcare.direct-ci.com
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations & group practices 12

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 5

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1811254592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD STE 110",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "630-946-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Liberty Ave Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152221029",
            "country_code": "US",
            "telephone_number": "412-230-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Irving St NW",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-8278",
            "fax_number": "202-877-6292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Church St NE Ste 400",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608957",
            "country_code": "US",
            "telephone_number": "678-239-0420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "AJEET",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036-152359",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD472494",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD472494",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036152359",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "080909",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036152359",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amehta209749@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd Ste 110",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.