Individual provider Active NPI

Vidushi Mehrotra, D.O.

  • Family Medicine Physician
  • Holly Springs, NC
National Provider Identifier
1811421647
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024-01384 Issued in NC
Practice address
101 Cotten LN
Holly Springs, NC 27540-8415
Phone
(919) 235-6555
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A16909 CA
Student in an Organized Health Care Education/Training Program 390200000X D9788403 CA
Family Medicine Physician 207Q00000X 2024-01384 NC Primary

Addresses

Primary practice location

101 Cotten LN
Holly Springs, NC 27540-8415

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1811421647MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, NC3 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
I20201005001358 NY Practitioner - Family Practice 9931528320 Reassigns benefits to 1 organization
I20220216000002 CA Practitioner - Family Practice 9931528320 Reassigns benefits to 1 organization
I20241009000350 NC Practitioner - Family Practice 9931528320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

101 Cotten LN
Holly Springs, NC 27540-8415
Phone (919) 235-6555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16909CAMDFamily Medicine Physician
2024-01384NCMDFamily Medicine Physician
D9788403CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians LLC Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Wake Specialty Physicians, LLC Family Medicine Current Accepting new patients
Montefiore Medical Center CurrentSince Aug 14, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Aug 14, 2020 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Oct 7, 2024 Accepting new patients
Usc Care Medical Group, Inc Family Medicine CurrentSince Feb 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2022 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Ste 1300
Los Angeles, CA 90033
Phone (323) 442-5900

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1045 N Lake Ave
Pasadena, CA 91104
Phone (626) 794-5737

101 Cotten Ln
Holly Springs, NC 27540
Phone (919) 235-6456

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

111 E 210th St
Bronx, NY 10467

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: vmehrotra556325@directhisp.wakemed.org

Organizations & group practices 10

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 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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1811421647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COTTEN LN",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408415",
            "telephone_number": "919-235-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHROTRA",
        "first_name": "VIDUSHI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16909",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "D9788403",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-01384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811421647",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.