Parag Mehta, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A50838 Issued in CA

Practice address

1294 W 6TH Street
Suite 105
San Pedro, CA 90731-2997

Phone

(310) 521-5990

Fax

(310) 521-5991

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1831164029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 W 6TH STREET",
            "address_2": "SUITE 105",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312997",
            "telephone_number": "310-521-5990",
            "fax_number": "310-521-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 W 6TH STREET",
            "address_2": "SUITE 105",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312997",
            "telephone_number": "310-521-5990",
            "fax_number": "310-521-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "PARAG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A50838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "130025763",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIN (MEDICARE)",
            "identifier": "318256",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "126390000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A508380",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN/DME PTAN",
            "identifier": "4515740001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831164029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B SHIELD",
            "identifier": "5422000A508380",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Plaza of San Pedro Inc.
• Medical Plaza of San Pedro Inc.
• Medical Plaza of San Pedro, Inc
• Ingrid Medina Horne
• Sanchita Mehra, DMD
• Angelo Joseph Mei
• Ronnie Lee Melendez
• Melissa F. Pedersen, Ma MFT Inc
• Melzer Chiropractic Group, Apc
• Danielle Marlene Mendez, LCSW

• Neurology Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.