MR. PRADEEP K MEHTA (NPI# 1366414443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366414443 |
| Entity Type | Individual |
| Full Name | MR. PRADEEP K MEHTA |
| Credential | M.D. |
| Practice Address |
3401 Conifer Dr Springfield IL 62711-8300 |
| Practice Telephone | 2177260967 |
| Practice Fax Number | 2177267633 |
| Mailing Telephone | 2177260967 |
| Mailing Fax Number | 2177267633 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-12-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
036-050314 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA | AM6379261 | 01 |
| HEALTHLINK CIGNA | 136860 | 01 | |
| RAILROAD MEDICARE | 390002369 | 01 | |
| GHP | 44741 | 01 | |
| BLUE CROSS BLUE SHIELD | 036050314 | 01 | |
| IL | 036-050314 | 05 | |
| IL | IL CONTROLLED SUBSTANCE | 336-015704 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790934081 | Pradeep Mehta | Dentist | 338 78th Street, Brooklyn, NY 11209 | 2008-09-11 |
| Street Address |
3401 CONIFER DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-8300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255302626 | Ashraf Tamizuddin | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-02-01 |
| 1730243015 | Xueguang Chen | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-12-20 |
| 1598788994 | Central Illinois Kidney & Dialysis Associates, Sc | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-07-26 |
| 1861431165 | Vikrampal S Bhatti | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-06-05 |
| 1457323669 | Lawrence J Smith | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-02-02 |
| 1326010570 | Allen S Krall | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1922477835 | Adult Hypertension and Kidney Specialists LLC | Internal Medicine | 2200 N Limestone Street Suite 114, Springfield, OH 45503-1171 | 2015-09-21 |
| 1255564829 | Richard Thomas Bilinsky | Internal Medicine | 3700 W Bluffs Rd, Springfield, IL 62711-9269 | 2009-08-31 |
| 1881884179 | Amit Pal Singh | Internal Medicine | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | 2007-08-01 |
| 1336278225 | Thomas H Ebert | Internal Medicine | Health New England, One Monarch Place, Springfield, MA 01144 | 2007-03-05 |
| 1851473730 | Pavan Chopra | Internal Medicine | 3355 Riverbend Drive Suite 200, Springfield, OR 97477-0000 | 2006-10-19 |
| 1073534004 | Eugene Springfield Nephrology Associates, PC | Internal Medicine | 3355 Riverbend Dr Ste 200, Springfield, OR 97477 | 2006-07-23 |
| 1255302626 | Ashraf Tamizuddin | Internal Medicine | 3401 Conifer Dr, Springfield, IL 62711-8300 | 2006-02-01 |
| 1568432581 | Maria Victoria Largoza | Internal Medicine | 100 W Sproul Rd Ste 224, Springfield, PA 19064-2033 | 2006-01-23 |
| 1740264365 | Nicolas A. Forero | Internal Medicine | 350 W Carpenter St, Springfield, IL 62702-4902 | 2005-12-06 |
| 1174516652 | Pius Kurian | Internal Medicine | 2200 N Limestone St Ste 114, Springfield, OH 45503-2692 | 2005-08-30 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
Please comment or provide details below to improve the information on MR. PRADEEP K MEHTA.
| 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.