NPIMap

Individual provider Active NPI

Kunal Shreyas Mehta

  • Vascular Surgery Physician
  • Portland, ME
National Provider Identifier
1992236368
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
20494 Issued in NH
Practice address
22 Bramhall St
Department of Vascular Surgery
Portland, ME 04102
Phone
(072) 662-0111
NPI assigned
Mar 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 20494 NH Primary

Addresses

Primary practice location

22 Bramhall St
Department of Vascular Surgery
Portland, ME 04102

Mailing address

22 Bramhall St
Department of Vascular Surgery
Portland, ME 04102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230919002028 ME Practitioner - Vascular Surgery 8325312531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Pittsburgh School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

9 Healthcare Dr
Suite 105
Biddeford, ME 04005-9445
Phone (207) 282-3666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)17
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20494NHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 5, 2023 Accepting new patients
Maine Medical Partners CurrentSince Sep 5, 2023 Accepting new patients
Mainehealth CurrentSince Sep 5, 2023 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Sep 5, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

9 Healthcare Dr
Ste 105
Biddeford, ME 04005
Phone (207) 282-3666

9 Healthcare Dr
Ste 105A
Biddeford, ME 04005

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

92 Campus Dr
Fl 3
Scarborough, ME 04074
Phone (207) 797-5753

Interoperability endpoints

  • Direct secure messaging: kmehta596738@direct.mmc.mainehealth.org

Organizations & group practices 8

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 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1992236368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "address_2": "DEPARTMENT OF VASCULAR SURGERY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "address_2": "DEPARTMENT OF VASCULAR SURGERY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "072-662-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KUNAL",
        "middle_name": "SHREYAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "20494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.