Individual provider Active NPI

Deepak M Kamat, MD PHD

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1174561807
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S1143 Issued in TX
Practice address
903 W Martin St
San Antonio, TX 78207
Phone
(210) 358-5437
Fax
(210) 358-6880
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301081822 MI
Pediatrics Physician 208000000X S1143 TX Primary

Addresses

Primary practice location

903 W Martin St
San Antonio, TX 78207

Mailing address

PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9500

Other practice location 1

3950 Beaubien - 1st FL
Childrens Hospital of MI
Detroit, MI 48201-2119
Phone (313) 832-8290

Other practice location 2

3950 Beaubien - 1st FL
Childrens Hospital of MI
Detroit, MI 48201-2119
Phone (313) 832-8290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190502001614 TX Practitioner - Pediatric Medicine 4981667714 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1143TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates Pediatrics CurrentSince May 15, 2019 Accepting new patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients

Locations

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

903 W Martin St
#B
San Antonio, TX 78207
Phone (210) 358-3441

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1174561807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9500",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-358-5437",
            "fax_number": "210-358-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Beaubien - 1st FL",
            "address_2": "Childrens Hospital of MI",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-832-8290",
            "fax_number": "313-993-0081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3950 Beaubien - 1st FL",
            "address_2": "Childrens Hospital of MI",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-832-8290",
            "fax_number": "313-993-0081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAT",
        "first_name": "DEEPAK",
        "middle_name": "M",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301081822",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S1143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.