Donald Albert Deshetler Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35076727D Issued in OH

Practice address

2000 Newark Granville Rd
Suite 100
Granville, OH 43023-9135

Phone

(740) 587-0087

Fax

(740) 587-0084

NPI assigned

Jun 30, 2005

Last updated

Feb 24, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Ohio State University College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
• Premier Home Health LLC Home health agency, Newark, OH, CCN 369198
• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddeshetler18836@copcp.medicity.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Central Ohio Primary Care Physicians Inc

  • Hospitalist Physician
  • Westerville, OH
  • NPI 1518398866
  NPD
• Central Ohio Primary Care Physicians, Inc.

  • Clinical Medical Laboratory
  • Westerville, OH
  • NPI 1639279045
  NPD

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

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation
• PF Development 15, LLC

  dba CenterWell Home Health II

  • Home Health Agency
  • Mount Vernon, OH
  • NPI 1821398447
  Care Compare affiliation
• Premier Home Health,LLC

  • Home Health Agency
  • Newark, OH
  • NPI 1164922191
  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1073510558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NEWARK GRANVILLE RD",
            "address_2": "SUITE 100",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239135",
            "telephone_number": "740-587-0087",
            "fax_number": "740-587-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEWARK GRANVILLE RD",
            "address_2": "SUITE 100",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239135",
            "telephone_number": "740-587-0087",
            "fax_number": "740-587-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHETLER",
        "first_name": "DONALD",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35076727D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2130956",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080148293",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Granville, OH
• Providers in Granville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.