Individual provider Active NPI

Deepak Khatri

  • Neurological Surgery Physician
  • New York, NY
National Provider Identifier
1447802533
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
P100369 Issued in NY
Practice address
130 E 77TH St
3 Black Hall
New York, NY 10075-1851
Phone
(212) 434-3691
NPI assigned
Jul 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X P100369 NY Primary

Addresses

Primary practice location

130 E 77TH St
3 Black Hall
New York, NY 10075-1851

Mailing address

130 E 77TH St
3 Black Hall
New York, NY 10075-1851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200716003308 NY Practitioner - NeurosurgeryPractitioner - General Surgery 6901220433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: General Surgery
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P100369NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince May 1, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Oct 15, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Oct 15, 2021 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

3316 Rochambeau Ave
Bronx, NY 10467
Phone (718) 920-5400

111 E 210th St
Bronx, NY 10467

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: dkhatri@montefioredirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1447802533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 77TH ST",
            "address_2": "3 BLACK HALL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 77TH ST",
            "address_2": "3 BLACK HALL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751851",
            "telephone_number": "212-434-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATRI",
        "first_name": "DEEPAK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "P100369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.