NPIMap

Individual provider Active NPI

Pushkar Mehra, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
National Provider Identifier
1891714093
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
19862 Issued in MA
Practice address
100 E Newton Street
Suite 407
Boston, MA 02118-2308
Phone
(617) 638-4350
Fax
(617) 638-4365
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 19862 MA Primary

Addresses

Primary practice location

100 E Newton Street
Suite 407
Boston, MA 02118-2308

Mailing address

100 E Newton Street
Suite 407
Boston, MA 02118-2308
Phone (617) 638-4350

Other identifiers 3

IdentifierTypeStateIssuer
X07996OtherMABCBS
0299944MedicaidMA
40351BMCOtherMAHCHP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060511000128 MA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 5890706436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Boston Univ Goldman School of Dental Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

100 E Newton St
G407
Boston, MA 02118-3552
Phone (617) 638-4350

110 Francis St
Suite 3a
Boston, MA 02215-5501
Phone (617) 632-9780

725 Albany St
Boston, MA 02118-2526
Phone (617) 638-1058

830 Harrison Ave
Boston, MA 02118-2905
Phone (617) 638-8000

840 Harrison Ave
Boston, MA 02118-2905
Phone (617) 638-8000

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19862MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Trustees of Boston University Oral and Maxillofacial Surgery CurrentSince Aug 28, 2000 Accepting new patients
Trustees of Boston University Past Accepting new patients

Locations

100 East Newton St
#G407
Boston, MA 02118
Phone (617) 638-4350

Interoperability endpoints

  • Direct secure messaging: pmehra11290@direct.bmc.masshiway.net

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 9

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891714093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON STREET",
            "address_2": "SUITE 407",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4350",
            "fax_number": "617-638-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NEWTON STREET",
            "address_2": "SUITE 407",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4350",
            "fax_number": "617-638-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRA",
        "first_name": "PUSHKAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "19862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "X07996",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0299944",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCHP",
            "identifier": "40351BMC",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.