Individual provider Active NPI

Deep Kukreti, MD

  • Family Medicine Physician
  • Laurel, MD
National Provider Identifier
1275507550
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOO52075 Issued in MD
Practice address
9900 Washington Blvd
Ste L
Laurel, MD 20723
Phone
(301) 776-4996
Fax
(301) 483-8810
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DOO52075 MD Primary

Addresses

Primary practice location

9900 Washington Blvd
Ste L
Laurel, MD 20723

Mailing address

9900 Washington Blvd
Ste L
Laurel, MD 20723
Phone (301) 776-4996

Other identifiers 1

IdentifierTypeStateIssuer
877610500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040521000892 DC Practitioner - General PracticePractitioner - Family Practice 8022009638 Reassigns benefits to 1 organization
I20070913000815 MD Practitioner - Family PracticePractitioner - Emergency Medicine 8022009638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11701 Roby Ave
Beltsville, MD 20705-1509
Phone (301) 725-4300

9900 Washington Blvd N
Suite L
Laurel, MD 20723-1972

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DOO52075MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Kukreti and Associates, LLC CurrentSince Sep 19, 2009 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Padder Health Services, LLC Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Rita Pabla MD Past Accepting new patients

Locations

11701 Roby Ave
Beltsville, MD 20705
Phone (301) 725-4300

9900 Washington Blvd N
Ste L
Laurel, MD 20723
Phone (301) 776-4996

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFEBAA
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1275507550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 WASHINGTON BLVD",
            "address_2": "STE L",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "301-776-4996",
            "fax_number": "301-483-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 WASHINGTON BLVD",
            "address_2": "STE L",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20723",
            "telephone_number": "301-776-4996",
            "fax_number": "301-483-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKRETI",
        "first_name": "DEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "DOO52075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "877610500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.