NPIMap

Individual provider Active NPI

Deepa D Kordick, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1396087094
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16629 Issued in NV
Practice address
8205 W Warm Springs Rd Ste 210
Las Vegas, NV 89113-3646
Phone
(702) 616-7660
Fax
(702) 616-7712
NPI assigned
Mar 20, 2013
Last updated
Nov 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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 16629 NV Primary

Addresses

Primary practice location

8205 W Warm Springs Rd Ste 210
Las Vegas, NV 89113-3646

Mailing address

8205 W Warm Springs Rd Ste 210
Las Vegas, NV 89113-3646
Phone (702) 616-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20170131001419 NV Practitioner - Family Practice 3173755873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2601 N Tenaya Way
Las Vegas, NV 89128-0427
Phone (702) 240-8155

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (NV) PC Family Medicine CurrentSince Sep 5, 2022 Accepting new patients
Centerwell Senior Primary Care (NV) PC Family Medicine CurrentSince Sep 5, 2022 Accepting new patients
Centerwell Senior Primary Care (NV) PC Family Medicine Past Accepting new patients
Centerwell Senior Primary Care NV P C Family Medicine Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

2601 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 233-4950

3129 N Rainbow Blvd
Las Vegas, NV 89108
Phone (725) 220-8457

4001 S Decatur Blvd
Ste 25
Las Vegas, NV 89103
Phone (725) 224-6967

6360 Boulder Hwy
Las Vegas, NV 89122
Phone (725) 228-4500

Interoperability endpoints

  • Direct secure messaging: deepa.kordick.1@29601.direct.athenahealth.com
  • Direct secure messaging: deepa.kordick@centerwell.eclinicaldirectplus.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1396087094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 W WARM SPRINGS RD STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133646",
            "telephone_number": "702-616-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8205 W WARM SPRINGS RD STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133646",
            "telephone_number": "702-616-7660",
            "fax_number": "702-616-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDICK",
        "first_name": "DEEPA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "16629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.