Individual provider Active NPI

Bhumi Mehta

  • Psychologist
  • Albany, GA
National Provider Identifier
1831665157
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
49763 Issued in FL
Practice address
125 Silver Leaf Dr
Albany, GA 31721-7704
Phone
(229) 854-4042
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY4179 GA
Psychologist 103T00000X 49763 FL Primary

Addresses

Primary practice location

125 Silver Leaf Dr
Albany, GA 31721-7704

Mailing address

125 Silver Leaf Dr
Albany, GA 31721-7704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324001045 FL Practitioner - Clinical Psychologist 9931516796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13245 Atlantic Blvd
Suite 4 328
Jacksonville, FL 32225-7121
Phone (904) 901-9184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49763FLMDPsychologist
PSY4179GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mehta Consulting Current Accepting new patients
Mehta Psychological Services Psychologist CurrentSince Nov 1, 2023 Accepting new patients

Locations

13245 Atlantic Blvd
Ste 4328
Jacksonville, FL 32225
Phone (904) 901-9184

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1831665157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SILVER LEAF DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317217704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SILVER LEAF DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317217704",
            "telephone_number": "229-854-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "BHUMI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY4179",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "49763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.