Individual provider Active NPI

Deepthiman K Gowda, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1245335850
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219634 Issued in NY
Practice address
506 Malcolm X Blvd
WP-522
New York, NY 10037-1802
Phone
(212) 939-2740
Fax
(212) 939-2759
NPI assigned
Sep 14, 2006
Last updated
Aug 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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 219634 NY Primary

Addresses

Primary practice location

506 Malcolm X Blvd
WP-522
New York, NY 10037-1802

Mailing address

506 Malcolm X Blvd
WP-522
New York, NY 10037-1802
Phone (212) 939-2740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041229000860 NY Practitioner - HospitalistPractitioner - Internal Medicine 5193783611 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The New York and Presbyterian Hosp Internal Medicine CurrentSince Dec 1, 2006 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince May 26, 2016 Accepting new patients
The New York and Presbyterian Hospital CurrentSince Dec 1, 2006 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jun 20, 2011 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
The New York and Presbyterian Hospital Internal Medicine Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jun 20, 2011 Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

506 Malcolm X Blvd
#522
New York, NY 10037
Phone (212) 491-1583

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

635 W 165th St
New York, NY 10032
Phone (212) 305-3039

21 Bloomingdale Rd
White Plains, NY 10605
Phone (914) 682-9100

21 Bloomingdale Rd
#159
White Plains, NY 10605
Phone (914) 682-9100

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1245335850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "WP-522",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-2740",
            "fax_number": "212-939-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "WP-522",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-2740",
            "fax_number": "212-939-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWDA",
        "first_name": "DEEPTHIMAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.