Organization Active NPI

Chirag P. Mehta, MD Inc.

  • Cardiovascular Disease Physician
  • Victorville, CA
National Provider Identifier
1922460047
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CHIRAG P. MEHTA, MD INC.
Practice address
12760 Hesperia Rd Ste C
Victorville, CA 92395-8305
Phone
(760) 338-0911
Fax
(760) 243-0471
NPI assigned
Mar 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Chirag P Mehta, M.D.NPI 1144483256
Title
Owner
Phone
(760) 338-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

12760 Hesperia Rd Ste C
Victorville, CA 92395-8305

Mailing address

12760 Hesperia Rd Ste C
Victorville, CA 92395-8305
Phone (760) 338-0911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170120002362 CA Part B Supplier - Clinic/Group Practice 8325320609 Receives reassigned benefits from 3 practitioners
Practice locations: Victorville, CA

National Provider Directory

National Provider Directory

Locations

1890 W Main St
Ste 130
Barstow, CA 92311
Phone (442) 255-4012

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1922460047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 HESPERIA RD STE C",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958305",
            "telephone_number": "760-338-0911",
            "fax_number": "760-243-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 HESPERIA RD STE C",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958305",
            "telephone_number": "760-338-0911",
            "fax_number": "760-243-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRAG P. MEHTA, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "CHIRAG",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-338-0911",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.