Individual provider Active NPI

Deepinder Kaur, M.D

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1356734917
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
278366 Issued in NY
Practice address
109 Shadow Oak LN
Fayetteville, NC 28303-5015
Phone
(937) 510-3465
NPI assigned
Mar 6, 2015
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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 278366 NY Primary

Addresses

Primary practice location

109 Shadow Oak LN
Fayetteville, NC 28303-5015

Mailing address

109 Shadow Oak LN
Fayetteville, NC 28303-5015

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20170413000245 DC Practitioner - Internal Medicine 7618295478 Reassigns benefits to 1 organization
I20180516001966 VA Practitioner - Internal Medicine 7618295478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10701 Rosemary Dr
Manassas, VA 20109-7282
Phone (703) 257-3000

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135693CAMDMarriage & Family Therapist
278366NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Mar 5, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine CurrentSince Feb 27, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 27, 2017 Accepting new patients

Locations

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 6W
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

12255 Fair Lakes Pkwy
Fairfax, VA 22033
Phone (703) 934-5700

10701 Rosemary Dr
Manassas, VA 20109
Phone (703) 257-3000

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 4

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": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1356734917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SHADOW OAK LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SHADOW OAK LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035015",
            "telephone_number": "937-510-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "DEEPINDER",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "278366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "10701 Rosemary Dr",
            "city": "Manassas",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201097282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.