NPIMap

Individual provider Active NPI

Sushil S Deshmukh, DO

  • Nephrology Physician
  • Seattle, WA
National Provider Identifier
1215308200
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OP60852077 Issued in WA
Practice address
904 7TH Ave
Seattle, WA 98104-1132
Phone
(206) 860-5575
NPI assigned
Oct 15, 2015
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OP60852077 WA Primary

Addresses

Primary practice location

904 7TH Ave
Seattle, WA 98104-1132

Mailing address

1145 Broadway FL 2
Seattle, WA 98122-4201
Phone (206) 860-5575

Other identifiers 1

IdentifierTypeStateIssuer
500745869MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190222002311 WA Practitioner - NephrologyPractitioner - Internal Medicine 3577810258 Reassigns benefits to 1 organization
I20230503000734 NM Practitioner - NephrologyPractitioner - Internal Medicine 3577810258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Nephrology Associates PLLCGroup PAC ID 5092877696, 7 clinicians
Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, shared by 3 NPIs, 31 clinicians

Practice addresses (Care Compare)

1551 S 2ND St
Gallup, NM 87301-5881
Phone (505) 863-7993

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60852077WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Nephrology Associates PLLC Nephrology CurrentSince Mar 28, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Apr 22, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Apr 22, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. CurrentSince May 23, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
The Polyclinic CurrentSince Jan 3, 2022 Accepting new patients
Peninsula Cancer Center LLC PastSince Jan 17, 2022 Accepting new patients
Red Rocks Dialysis, LLC Past Accepting new patients

Locations

1551 S Second St
Gallup, NM 87301
Phone (505) 542-0090

1801 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7933

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 726-6875

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

1145 Broadway
Seattle, WA 98122

1145 Broadway
Fl 2
Seattle, WA 98122
Phone (206) 860-3509

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

Organizations & group practices 9

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 5

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1215308200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY FL 2",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-860-5575",
            "fax_number": "800-272-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-860-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHMUKH",
        "first_name": "SUSHIL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "OP60852077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500745869",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.