NPIMap

Organization Active NPI

Terre Haute Pulmonary & Pediatric Clinic, LLC

Doing business as Sullivan Clinic 2 Dr Deshpande

  • Pulmonary Disease Physician
  • Sullivan, IN
National Provider Identifier
1427119809
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
TERRE HAUTE PULMONARY & PEDIATRIC CLINIC, LLC
Doing business as
Sullivan Clinic 2 Dr Deshpande
Practice address
2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Phone
(812) 234-6053
Fax
(812) 234-1722
NPI assigned
Dec 12, 2006
Reactivated
Apr 30, 2008
Last updated
Sep 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Authorized official

Name
Trupti A Bhuptani, MDNPI 1255311221
Title
Co Owner MD
Phone
(812) 234-6053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

2229 Mary Sherman Dr
Sullivan, IN 47882-7633

Mailing address

4525 S Springhill JCT
Terre Haute, IN 47802-4563
Phone (812) 234-6053

Other identifiers 1

IdentifierTypeStateIssuer
200391150KMedicaidIN

Other names 1

  • Sullivan Clinic 2 Dr Deshpande Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040527001234 IN Part B Supplier - Clinic/Group Practice 2062493752 Receives reassigned benefits from 10 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greencastle, IN; Washington, IN; Sullivan, IN; Terre Haute, IN

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Greencastle Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1427119809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 S SPRINGHILL JCT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024563",
            "telephone_number": "812-234-6053",
            "fax_number": "812-234-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 MARY SHERMAN DR",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827633",
            "telephone_number": "812-234-6053",
            "fax_number": "812-234-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRE HAUTE PULMONARY & PEDIATRIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-09-29",
        "deactivation_date": "2007-06-19",
        "reactivation_date": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "BHUPTANI",
        "authorized_official_first_name": "TRUPTI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO OWNER MD",
        "authorized_official_telephone_number": "812-234-6053",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200391150K",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Clinic 2 Dr Deshpande",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sullivan, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.