Individual provider Active NPI

Jayesh R Mehta

  • Pulmonary Disease Physician
  • Nanuet, NY
National Provider Identifier
1902995558
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
200651 Issued in NY
Practice address
55 Old Nyack Tpke
Suite 503
Nanuet, NY 10954-2461
Phone
(845) 627-2800
Fax
(845) 627-7827
NPI assigned
Oct 12, 2006
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200651 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 200651 NY
Pulmonary Disease Physician 207RP1001X 200651 NY Primary

Addresses

Primary practice location

55 Old Nyack Tpke
Suite 503
Nanuet, NY 10954-2461

Mailing address

55 Old Nyack Tpke
Suite 503
Nanuet, NY 10954-2461
Phone (845) 627-2800

Other identifiers 1

IdentifierTypeStateIssuer
01832099MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060126000221 NY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 9133133499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 987-3906

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200651NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients

Locations

55 Old Turnpike Rd
Ste 503
Nanuet, NY 10954
Phone (845) 623-9400

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1902995558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OLD NYACK TPKE",
            "address_2": "SUITE 503",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-627-2800",
            "fax_number": "845-627-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OLD NYACK TPKE",
            "address_2": "SUITE 503",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-627-2800",
            "fax_number": "845-627-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "JAYESH",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "200651",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "200651",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "200651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01832099",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

Verify at the official NPI Registry.