Darshan A Deole, DPT

Individual provider Active NPI Physical Therapist · Raytown, MO

NPI 1134416696 · NPPES record last updated Apr 19, 2016

Key facts

NPI
1134416696
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2011021971 (MO)
Practice address
10801 E State Route 350
Raytown, MO 64138-2367
Phone
(816) 737-5500
Fax
(816) 737-5504
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serc Rebabilitation Partners, LLC (212 clinicians)

Practice addresses (Care Compare)

10801 E State Route 350
Serc South Raytown
Raytown, MO 64138-2367
Phone (816) 737-5502

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110823000641 MO Practitioner - Physical Therapist in Private Practice 3678743036 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2011021971MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serc Rebabilitation Partners, LLC Physical Therapist Current
since Dec 3, 2012
Accepting new patients
Serc Rebabilitation Partners, LLC Physical Therapist Current
since Dec 3, 2012
Accepting new patients
Serc Rehabilitation Partners, LLC Physical Therapist Current Accepting new patients
Mid America Balance Institute of Cass County Missouri Past Accepting new patients
Spine and Extremity Rehabilitation Center of Raytown Inc Physical Therapist Past Accepting new patients
Serc Rehabilitation Partners LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051

109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280

11902 Blue Ridge Ext
Ste 11906B
Grandview, MO 64030
Phone (816) 298-6120

10801 E State Route 350
Ste B
Raytown, MO 64138
Phone (816) 737-5500

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2011021971 MO Yes

Addresses

Primary practice location

10801 E State Route 350
Raytown, MO 64138-2367

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (816) 226-4011

Other identifiers

IdentifierTypeStateIssuer
45791024OtherBCBS KC
MA4370055OtherMOMEDICARE PTAN

Other providers in Raytown, MO

All providers in Raytown, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.