NPIMap

Individual provider Active NPI

Deepak Dhawan, MD

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1184727182
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A79078 Issued in CA
Practice address
13851 E 14TH St Ste 305
San Leandro, CA 94578-2630
Phone
(510) 351-1193
Fax
(510) 351-6456
NPI assigned
Sep 6, 2006
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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 A79078 CA Primary

Addresses

Primary practice location

13851 E 14TH St Ste 305
San Leandro, CA 94578-2630

Mailing address

2345 Country Hills Dr
Antioch, CA 94509-7319
Phone (925) 418-0159

Other practice location 1

20400 Lake Chabot Rd Ste 102
Castro Valley, CA 94546-5314
Phone (510) 247-9227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040205000635 CA Practitioner - Internal Medicine 6002709839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Epic CareGroup PAC ID 5890053094, 54 clinicians

Practice addresses (Care Compare)

13851 E 14TH St
Suite 305
San Leandro, CA 94578-2630
Phone (510) 351-1193

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Care CurrentSince Oct 1, 2019 Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Hayward Sisters Hospital Past Accepting new patients

Locations

2345 Country Hills Dr
Antioch, CA 94509
Phone (925) 418-0278

20400 Lake Chabot Rd
Ste 102
Castro Valley, CA 94546
Phone (510) 247-9227

13851 E 14th St
Ste 305
San Leandro, CA 94578
Phone (510) 351-1193

13851 E 14th St
Ste 308
San Leandro, CA 94578
Phone (510) 351-1193

Interoperability endpoints

  • Direct secure messaging: ddhawan130068@ehr.johnmuirhealth.com

Organizations & group practices 3

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 12

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1184727182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097319",
            "telephone_number": "925-418-0159",
            "fax_number": "925-978-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST STE 305",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782630",
            "telephone_number": "510-351-1193",
            "fax_number": "510-351-6456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20400 Lake Chabot Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465314",
            "country_code": "US",
            "telephone_number": "510-247-9227",
            "fax_number": "510-247-9241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHAWAN",
        "first_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A79078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.