Deepak Kademani, M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

46570 Issued in MN

Practice address

2380 Troop Dr Unit 202
Sartell, MN 56377-4637

Phone

(320) 257-9555

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Maxillofacial Surgery

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Oral and Facial Surgery PLLCGroup PAC ID 7517383987, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Minnesota Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Sartell, MN
  • NPI 1194363275

  Oral & Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Maxillofacial and Oral Surgery PA

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Minneapolis, MN
  • NPI 1821010497
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Memorial Health Care

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1356327431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 TROOP DR UNIT 202",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-257-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 TROOP DR UNIT 202",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-257-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADEMANI",
        "first_name": "DEEPAK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "46570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375453700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon M Anderson DC, LTD
• Kimberly Teresa Jordan
• Alison J Jorgensen, LPCC
• Eberle Susan Irene Juhl
• Matthew Stephen Justin
• Michelle Lynn Kaiser, M.S., LPCC
• Sara Elizabeth Kalis
• Samantha Kalkbrenner
• Imo I Kalla, NP
• Rebecca Kalla

• Oral & Maxillofacial Surgery (D.M.D.) in Sartell, MN
• Providers in Sartell, MN by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.