Individual provider Active NPI

Mukund Deshmukh, MD

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1205930377
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A51789 Issued in CA
Practice address
5900 Brockton Ave
Suite a Riverside Psychiatric Medical Group
Riverside, CA 92506-1862
Phone
(951) 275-8500
Fax
(951) 275-8560
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A51789 CA Primary

Addresses

Primary practice location

5900 Brockton Ave
Suite a Riverside Psychiatric Medical Group
Riverside, CA 92506-1862

Mailing address

PO Box 2089
Suite a Riverside Psychiatric Medical Group
Artesia, CA 90702-2089
Phone (951) 926-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080519000492 CA Practitioner - Psychiatry 9830268747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5353 G St
Chino, CA 91710-5249
Phone (909) 590-3700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51789CAMDPsychiatry Physician

Organizations & group practices 1

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1205930377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089",
            "address_2": "SUITE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907022089",
            "telephone_number": "951-926-1014",
            "fax_number": "951-926-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BROCKTON AVE",
            "address_2": "SUITE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061862",
            "telephone_number": "951-275-8500",
            "fax_number": "951-275-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHMUKH",
        "first_name": "MUKUND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A51789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.