Individual provider Active NPI

Deepak Khanna, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1164919783
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021567 Issued in PA
Practice address
501 S 54TH St
Philadelphia, PA 19143-1900
Phone
(215) 748-9707
Fax
(215) 748-9708
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS021567 PA Primary

Addresses

Primary practice location

501 S 54TH St
Philadelphia, PA 19143-1900

Mailing address

5 Lipnick LN
Edison, NJ 08820-1955
Phone (732) 343-5242

Other practice location 1

111 N Washington Ave
Scranton, PA 18503
Phone (570) 343-2383

Other practice location 2

2501 W Lehigh Ave
Philadelphia, PA 19132-3207
Phone (215) 227-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20211201000419 PA Practitioner - Family Practice 2466702857 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

501 S 54TH St
Philadelphia, PA 19143-1900

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 25, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Sep 3, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Sep 3, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 25, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine Current Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

800 Spruce St
#1
William Penn Annex West, PA 19107
Phone (215) 829-2222

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1164919783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LIPNICK LN",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201955",
            "telephone_number": "732-343-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9707",
            "fax_number": "215-748-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "18503",
            "country_code": "US",
            "telephone_number": "570-343-2383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 W Lehigh Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191323207",
            "country_code": "US",
            "telephone_number": "215-227-0300",
            "fax_number": "215-227-0302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "DEEPAK",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.