Organization Active NPI

Deepak Sarwal, MD, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Dayton, OH
National Provider Identifier
1417130337
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35077166 Issued in OH
Legal business name
DEEPAK SARWAL, MD, LLC
Practice address
2205 Miamisburg Centerville Rd
Dayton, OH 45459-3816
Phone
(937) 291-0839
NPI assigned
Dec 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Dr. Deepak Sarwal, M.D.NPI 1235159559
Title
Owner
Phone
(937) 291-0839

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 35077166 OH Primary

Addresses

Primary practice location

2205 Miamisburg Centerville Rd
Dayton, OH 45459-3816

Mailing address

PO Box 186
Bellbrook, OH 45305-0186
Phone (937) 291-0839

Other practice location 1

5563 Far Hills Ave
Kettering, OH 45429-2225
Phone (937) 291-0839

Other identifiers 2

IdentifierTypeStateIssuer
2937022 GROUPMedicaidOH
2141079MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050216000913 OH Part B Supplier - Clinic/Group Practice 9830141902 Receives reassigned benefits from 1 practitioner
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

2205 Miamisburg Centerville Rd
Dayton, OH 45459
Phone (937) 291-0839

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1417130337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453050186",
            "telephone_number": "937-291-0839",
            "fax_number": "937-291-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MIAMISBURG CENTERVILLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593816",
            "telephone_number": "937-291-0839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5563 Far Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454292225",
            "country_code": "US",
            "telephone_number": "937-291-0839",
            "fax_number": "937-291-0854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEEPAK SARWAL, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SARWAL",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-291-0839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35077166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2937022 GROUP",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2141079",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.