Individual provider Active NPI

Vikram Mehta, M.D.

  • Family Medicine Physician
  • Elkhart, IN
National Provider Identifier
1841293461
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01059521A Issued in IN
Practice address
303 S Nappanee St
Elkhart, IN 46514-2066
Phone
(574) 296-3296
Fax
(574) 296-3309
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01059521A IN Primary

Addresses

Primary practice location

303 S Nappanee St
Elkhart, IN 46514-2066

Mailing address

PO Box 2968
Elkhart, IN 46515-2968
Phone (574) 296-3296

Other identifiers 1

IdentifierTypeStateIssuer
200488710MedicaidIN

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
I20041006000345 IN Practitioner - Family Practice 1355300369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group Indiana LLCGroup PAC ID 2365341674, 28 clinicians

Practice addresses (Care Compare)

25651 County Rd
Suite 20
Elkhart, IN 46517-2310
Phone (574) 522-1201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059521AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Indiana, LLC CurrentSince Sep 1, 2004 Accepting new patients
Privia Medical Group Indiana, LLC CurrentSince Sep 1, 2004 Accepting new patients
Privia Medical Group Indiana, LLC Current Accepting new patients

Locations

25651 County Road 20
Elkhart, IN 46517
Phone (219) 522-1201

303 S Nappanee St
Elkhart, IN 46514

Interoperability endpoints

  • Direct secure messaging: vikram.mehta.1@31626.direct.athenahealth.com
  • Direct secure messaging: vikram.mehta@elkhartc.eclinicaldirectplus.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1841293461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465152968",
            "telephone_number": "574-296-3296",
            "fax_number": "574-296-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142066",
            "telephone_number": "574-296-3296",
            "fax_number": "574-296-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "VIKRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01059521A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200488710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.