Individual provider Active NPI

Pooja Asim Mehta, DO

  • Pediatrics Physician
  • Palo Alto, CA
National Provider Identifier
1912491804
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A19613 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.072989 IL
Pediatrics Physician 208000000X 20A19613 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210814000251 IL Practitioner - Pediatric Medicine 2567866437 Reassigns benefits to 1 organization
I20220623001680 CA Practitioner - Pediatric Medicine 2567866437 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19613CAMDClinical Psychologist
20A19613CAMDPediatrics Physician
125.072989ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Pediatrics CurrentSince Jul 1, 2021 Accepting new patients
Rush University Medical Center CurrentSince Jul 1, 2021 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Jun 14, 2022 Accepting new patients

Locations

1359 Park Ave
Alameda, CA 94501
Phone (510) 523-8162

2915 Telegraph Ave
Ste 200
Berkeley, CA 94705
Phone (510) 647-0893

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1645 W Jackson Blvd
Ste 200
Chicago, IL 60612
Phone (312) 492-7337

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1650 W Harrison St
Ste 466
Chicago, IL 60612
Phone (312) 942-0312

1645 W Jackson Blvd
Chicago, IL 60612
Phone (312) 942-2200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pmehta642112@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1912491804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "POOJA",
        "middle_name": "ASIM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.072989",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A19613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.