Individual provider Active NPI

Deepak Khemka, M.D.

  • Psychiatry Physician
  • Fort Wayne, IN
National Provider Identifier
1396922977
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01085048A Issued in IN
Practice address
1720 Beacon St
Fort Wayne, IN 46805-4749
Phone
(260) 373-8000
NPI assigned
Jan 26, 2008
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 694L MS
Psychiatry Physician 2084P0800X 01085048A IN Primary

Addresses

Primary practice location

1720 Beacon St
Fort Wayne, IN 46805-4749

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

2117 Broadway Dr
Hattiesburg, MS 39402-3210
Phone (601) 288-8042

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address dkhemka453554@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IN2 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
I20120926000387 MS Practitioner - Psychiatry 0345499927 Reassigns benefits to 1 organization
I20210401001832 IN Practitioner - Psychiatry 0345499927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians
Park Center IncGroup PAC ID 5991794794, 47 clinicians

Practice addresses (Care Compare)

1720 Beacon St
Fort Wayne, IN 46805-4749
Phone (260) 373-8000

2117 Broadway Dr
Hattiesburg, MS 39402-3210
Phone (601) 288-8050

2255 Broadway Dr
Hattiesburg, MS 39402-3254
Phone (601) 288-4800

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-4273

6051 US Hwy 49 S
Hattiesburg, MS 39401-7200
Phone (601) 288-7000

909 E State Blvd
Fort Wayne, IN 46805-3458
Phone (260) 481-2718

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
694LMSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Sep 1, 2012 Accepting new patients
Forrest County General Hospital CurrentSince Sep 1, 2012 Accepting new patients
Park Center Inc CurrentSince Apr 30, 2021 Accepting new patients
Park Center Inc CurrentSince Apr 30, 2021 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Parkview Health System, Inc. CurrentSince Apr 30, 2021 Accepting new patients
Parkview Hospital, Inc. Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11104 Parkview Circle Dr
Ste 410
Fort Wayne, IN 46845
Phone (260) 266-5260

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

1720 Beacon St
Fort Wayne, IN 46805
Phone (260) 373-7500

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

1 Lincoln Pkwy
Ste 202
Hattiesburg, MS 39402
Phone (601) 288-8050

2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050

Interoperability endpoints

  • Direct secure messaging: dkhemka453554@direct.parkviewexchange.com

Organizations & group practices 7

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": "1201305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1396922977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 BEACON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054749",
            "telephone_number": "260-373-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2117 Broadway Dr",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394023210",
            "country_code": "US",
            "telephone_number": "601-288-8042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEMKA",
        "first_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-26",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "694L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01085048A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkhemka453554@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.