Pratibha Deshpande MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRATIBHA DESHPANDE MD PA

Practice address

507 Gaslight Blvd
Lufkin, TX 75904-3127

Phone

(936) 366-8056

NPI assigned

Jan 14, 2021

Organization subpart

No

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

Authorized official

Name

Pratibha Amol Deshpande, MDNPI 1164511408

Title

MD

Phone

(936) 366-8056

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pratibha Amol Deshpande, M.D.

  • Internal Medicine Physician
  • Lufkin, TX
  • NPI 1164511408
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1407445455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043127",
            "telephone_number": "936-366-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043127",
            "telephone_number": "936-366-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATIBHA DESHPANDE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "DESHPANDE",
        "authorized_official_first_name": "PRATIBHA",
        "authorized_official_middle_name": "AMOL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "936-366-8056",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bryan Pool, DC
• Robin Pool
• Brittanie Porter, CRNA
• Melanie Potter, PA
• Dwaina Lynn Powell, LCDC
• Praxair Healthcare Services, Inc
• Preferred Home Health, LP
• Usha Premkumar
• Present Tense Therapy, PLLC
• Latisha Ann Primrose, LPC

• Internal Medicine Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.