Individual provider Active NPI

Deepak Venkataraman, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Mullica Hill, NJ
National Provider Identifier
1417842030
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
700 Mullica Hill Road Inspira Health Mullica Hill, Grad
Mullica Hill, NJ 08062
Phone
(856) 508-3291
NPI assigned
Jun 12, 2025
Reactivated
Aug 24, 2026
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

700 Mullica Hill Road Inspira Health Mullica Hill, Grad
Mullica Hill, NJ 08062

Mailing address

700 Mullica Hill Road Inspira Health Mullica Hill, Grad
Mullica Hill, NJ 08062
Phone (856) 508-3291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1417842030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MULLICA HILL ROAD INSPIRA HEALTH MULLICA HILL, GRAD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-508-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MULLICA HILL ROAD INSPIRA HEALTH MULLICA HILL, GRAD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-508-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATARAMAN",
        "first_name": "DEEPAK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-12",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "deactivation_date": "2026-06-15",
        "reactivation_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.