NPIMap

Individual provider Active NPI

Deepak S. Jaiswal, M.D.

  • Internal Medicine Physician
  • Durant, OK
National Provider Identifier
1386698728
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18645 Issued in OK
Practice address
702 Bryan Dr
Suite 100
Durant, OK 74701-7000
Phone
(580) 924-4704
Fax
(580) 924-6001
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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 18645 OK Primary

Addresses

Primary practice location

702 Bryan Dr
Suite 100
Durant, OK 74701-7000

Mailing address

702 Bryan Dr
Suite 100
Durant, OK 74701-7000
Phone (580) 924-4704

Other identifiers 3

IdentifierTypeStateIssuer
100207270BOtherOKINDIVIDUAL MK NUMBER
100207270AMedicaidOK
242323400OtherOKINDIVIDUAL MC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070222000743 OK Practitioner - Internal Medicine 9537169743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jaiswal Clinic PLLCGroup PAC ID 4385717586, 2 clinicians

Practice addresses (Care Compare)

702 Bryan Dr
Suite 100
Durant, OK 74701-7031
Phone (580) 924-4704

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Walk in Clinic LLC CurrentSince Nov 1, 2015 Accepting new patients
Jaiswal Clinic PLLC Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
Durant Hma Inc. Internal Medicine Past Accepting new patients

Locations

702 Bryan Dr
Ste 200
Durant, OK 74701
Phone (580) 924-4707

702 Bryan Dr
Ste 100
Durant, OK 74701
Phone (580) 924-4704

Interoperability endpoints

  • Direct secure messaging: deepak.jaiswal@jaiswal.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FEIEAA

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1386698728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR",
            "address_2": "SUITE 100",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017000",
            "telephone_number": "580-924-4704",
            "fax_number": "580-924-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR",
            "address_2": "SUITE 100",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017000",
            "telephone_number": "580-924-4704",
            "fax_number": "580-924-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAISWAL",
        "first_name": "DEEPAK",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MK NUMBER",
            "identifier": "100207270B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100207270A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MC NUMBER",
            "identifier": "242323400",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.