NPIMap

Organization Active NPI

Mahajan Therapeutics, LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
National Provider Identifier
1952734469
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MAHAJAN THERAPEUTICS, LLC
Practice address
2954 Walnut St
Portsmouth, OH 45662-4828
Phone
(740) 776-2785
Fax
(740) 776-2793
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2954 Walnut St
Portsmouth, OH 45662-4828

Mailing address

2954 Walnut St
Portsmouth, OH 45662-4828
Phone (740) 776-2785

Other practice location 1

2117 S 7th Street
Suites 3, 5, and 7
Ironton, OH 45638
Phone (740) 533-9922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160809001647 OH Part B Supplier - Clinic/Group Practice 8820236524 Receives reassigned benefits from 40 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dayton, OH; Portsmouth, OH; Wheelersburg, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2154214Mahajan Therapeutics, LLC2954 Walnut Street, Portsmouth, OH 45662Certificate of waiverSep 6, 2026

National Provider Directory

National Provider Directory

Locations

6300 N Main St
Dayton, OH 45415
Phone (937) 275-1500

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1952734469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2954 WALNUT ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624828",
            "telephone_number": "740-776-2785",
            "fax_number": "740-776-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2954 WALNUT ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624828",
            "telephone_number": "740-776-2785",
            "fax_number": "740-776-2793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2117 S 7th Street",
            "address_2": "Suites 3, 5, and 7",
            "address_purpose": "LOCATION",
            "city": "Ironton",
            "state": "OH",
            "postal_code": "45638",
            "country_code": "US",
            "telephone_number": "740-533-9922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAHAJAN THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.