Active NPI
Jeet Ram Mehta, MD
- Colon & Rectal Surgery Physician
- Youngstown, OH
National Provider Identifier
1861485591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 35-03-6259-M
- Practice address
- 16 Colonial Dr
Youngstown, OH 44505-2137 - Phone
- (330) 759-8545
- Fax
- (330) 759-8543
- NPI assigned
- Aug 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | 35-03-6259-M | OH | Primary |
| Colon & Rectal Surgery Physician | 208C00000X | MD015942E | PA |
Addresses
Primary practice location
16 Colonial Dr
Youngstown, OH 44505-2137
Mailing address
16 Colonial Dr
Youngstown, OH 44505-2137
Phone (330) 759-8545
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1400021 | Other | UHC | |
| 3525578001 | Other | CIGNA | |
| CO100187 | Other | PA | HIGHMARK PA BLUE SHIELD |
| 0965835 | Medicaid | OH | |
| 3233482 | Other | PA | SUPERBLUE HMO |
| 0356118 | Medicaid | OH | |
| 151219 | Other | PA | KEYSTONE HEALTH PLAN |
| 000000129554 | Other | OH | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD015942E | PA | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260921600000",
"number": "1861485591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 COLONIAL DR",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445052137",
"telephone_number": "330-759-8545",
"fax_number": "330-759-8543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 COLONIAL DR",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445052137",
"telephone_number": "330-759-8545",
"fax_number": "330-759-8543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "JEET",
"middle_name": "RAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-29",
"last_updated": "2009-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "OH",
"license": "35-03-6259-M",
"primary": true
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "PA",
"license": "MD015942E",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "1400021",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3525578001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK PA BLUE SHIELD",
"identifier": "CO100187",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0965835",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERBLUE HMO",
"identifier": "3233482",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0356118",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN",
"identifier": "151219",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000129554",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.