DR. GAUTAM RAJU MEHTA (NPI# 1336481779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336481779 |
| Entity Type | Individual |
| Full Name | DR. GAUTAM RAJU MEHTA |
| Other Name | RAJU MEHTA |
| Credential | MBBS |
| Practice Address |
200 1st St Sw Rochester MN 55905-2600 |
| Mailing Address |
200 1st St Sw Rochester MN 55905-0001 |
| Practice Telephone | (507) 284-2511 |
| Mailing Telephone | (507) 284-2511 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036140001 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
61685 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4440 W 95th St, Oak Lawn, IL 604532600 | 7086845673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952620189 | Gautam U Mehta | Neurological Surgery | 2100 W 3rd St, Los Angeles, CA 90057 | 2010-05-27 |
| Street Address |
200 1ST ST SW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55905-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031875 | Christine Maria Miller | Radiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-05-27 |
| 1184225898 | Ellen Renne Larkin | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-08 |
| 1972104180 | Malinda Marie Wilcox | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1720689920 | Tammy Lynn Perttula | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1619578721 | Aaron Anderson | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1093316598 | Rebecca Lea Parttridge | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-03 |
| 1710588173 | Eduardo Gabriel Danduch | Student in an Organized Health Care Education/Training Program | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-03 |
| 1962002030 | Taylor Jeanne Jamison | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-28 |
| 1619577640 | Hayden Taylor Middleton | Student in an Organized Health Care Education/Training Program | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-28 |
| 1295335461 | Vivek Sureshchandran Tharayil | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306333109 | John Warren Kirby | Radiology | 200 1st St Sw # 507284, Rochester, MN 55905 | 2018-04-17 |
| 1720528417 | Erin Hamilton | Social Worker | 200 First St. Sw, Rochester, MN 55905 | 2017-03-01 |
| 1033482872 | Mayo Foundation for Medical Education & Research | Durable Medical Equipment & Medical Supplies | 200 1st St Sw Ste S148, Rochester, MN 55905 | 2012-02-09 |
| 1871829937 | Karen Christine Lundholm | Pharmacist | 1216 2nd Street Sw, Rochester, MN 55905 | 2009-10-26 |
| 1689800260 | Matthew Basiaga | Pediatrics | 200 1st Ave Ne, Rochester, MN 55905 | 2009-06-09 |
| 1366680720 | Megan H. Nelson | Surgery | 200 First Street S.w., Rochester, MN 55905 | 2009-01-23 |
| 1639352198 | Jill Marie Hunchis | Nurse Practitioner | 200 First St Sw, Rochester, MN 55905 | 2007-12-07 |
| 1619027265 | Thomas Phillip Moyer | Spec/Tech, Pathology | 200 1st Street Southwest, H-730d, Rochester, MN 55905 | 2007-01-12 |
| 1568544070 | Lisa Ann Schimmenti | Medical Genetics | 200 1st Swst, Rochester, MN 55905 | 2006-10-20 |
| 1558302315 | Robert J Pignolo | Internal Medicine | 200 1st Street Sw, Rochester, MN 55905 | 2006-06-10 |
| Find all providers in zip 55905 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730325812 | Ranime Saliba | Internal Medicine | 755 Jefferson Rd Ste 110, Rochester, NY 14623-3270 | 2008-12-19 |
| 1174798102 | Christina Ann Rager | Internal Medicine | 1561 Long Pond Rd Ste 408, Rochester, NY 14626-4135 | 2008-04-30 |
| 1285678201 | Paul Michael Passamonte | Internal Medicine | 1790 Long Pond Rd, Rochester, NY 14606-4032 | 2006-06-16 |
| 1598310161 | Vincent Evan Derienzo | Internal Medicine | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2019-08-09 |
| 1548786171 | Aimee Elizabeth Raponi | Internal Medicine | 601 Elmwood Ave, Rochester, NY 14642 | 2017-08-15 |
| 1801242060 | Abdelrahman Mohamedosman Ali Ahmed | Internal Medicine | 200 1st St Sw, Rochester, MN 55905 | 2016-05-06 |
| 1851775753 | Osama M Mukhtar | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2015-07-10 |
| 1760889182 | Xavier Fonseca Fuentes | Internal Medicine | 200 1st St Sw, Rochester, MN 55905 | 2014-12-01 |
| 1629490438 | Jose Bernardo Contreras Jr. | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-2510 | 2014-01-14 |
| 1104268614 | Crystal Breighner | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2013-07-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.