NPIMap

Individual provider Active NPI

Pravin Deshmukh, M.D.

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1073511200
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101251468 Issued in VA
Practice address
12320 W Broad St Ste 204
Richmond, VA 23233-7603
Phone
(804) 612-2980
Fax
(804) 360-2437
NPI assigned
Jul 12, 2005
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101251468 VA Primary

Addresses

Primary practice location

12320 W Broad St Ste 204
Richmond, VA 23233-7603

Mailing address

PO Box 639970
Cincinnati, OH 45263-9970
Phone (804) 612-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120727000002 VA Practitioner - Internal Medicine 0244212017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Mar 1, 2019 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC CurrentSince Mar 1, 2019 Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients
Nuestra Clinica del Valle, Inc. Past Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

12320 W Broad St
Ste 204
Richmond, VA 23233
Phone (804) 612-2980

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Organizations & group practices 6

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1073511200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639970",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639970",
            "telephone_number": "804-612-2980",
            "fax_number": "804-360-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12320 W BROAD ST STE 204",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232337603",
            "telephone_number": "804-612-2980",
            "fax_number": "804-360-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHMUKH",
        "first_name": "PRAVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.