Active NPI
Martin M Deasy, M.D.
- Psychiatry Physician
- San Francisco, CA
National Provider Identifier
1295810760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C53228
- Practice address
- 420 Lake St Apt 3
San Francisco, CA 94118-1333 - Phone
- (845) 853-6414
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME88133 | FL | |
| Psychiatry Physician | 2084P0800X | 211990 | NY | |
| Psychiatry Physician | 2084P0800X | C53228 | CA | Primary |
Addresses
Primary practice location
420 Lake St Apt 3
San Francisco, CA 94118-1333
Mailing address
420 Lake St Apt 3
San Francisco, CA 94118-1333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53228 | CA | MD | General Practice Dentistry |
| ME88133 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1295810760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 LAKE ST APT 3",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941181333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 LAKE ST APT 3",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941181333",
"telephone_number": "845-853-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEASY",
"first_name": "MARTIN",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME88133",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "211990",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C53228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.