Individual provider Active NPI

Nikita Mehrotra, DNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1902594039
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028113 Issued in IL
Practice address
1150 W Fullerton Ave Ste 250
Chicago, IL 60614-8160
Phone
(224) 273-7805
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209028113 IL Primary

Addresses

Primary practice location

1150 W Fullerton Ave Ste 250
Chicago, IL 60614-8160

Mailing address

1150 W Fullerton Ave Ste 250
Chicago, IL 60614-8160
Phone (224) 273-7805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230924000018 IL Practitioner - Nurse Practitioner 3577917616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presence Healthcare ServicesGroup PAC ID 2860396769, 69 clinicians

Practice addresses (Care Compare)

2233 W Division St
Chicago, IL 60622-8151
Phone (312) 770-2000

Hospital & facility affiliations

  • Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209028113ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Healthcare Services CurrentSince Jan 15, 2025 Accepting new patients
Presence Healthcare Services Current Accepting new patients
Presence Healthcare Services Family PastSince Sep 17, 2023 Accepting new patients

Locations

1150 W Fullerton Ave
Ste 250
Chicago, IL 60614
Phone (224) 273-7805

331 W Surf St
Ste 801
Chicago, IL 60657

62311 Collection Ctr Dr
Chicago, IL 60693

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": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1902594039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W FULLERTON AVE STE 250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606148160",
            "telephone_number": "224-273-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W FULLERTON AVE STE 250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606148160",
            "telephone_number": "224-273-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHROTRA",
        "first_name": "NIKITA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.