Organization Active NPI

Mukund Deshmukh MD Inc Apc

  • Psychiatry Physician
  • Orange, CA
National Provider Identifier
1508967381
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A051789 Issued in CA
Legal business name
MUKUND DESHMUKH MD INC APC
Practice address
6143 E Cliffway Dr
Orange, CA 92869
Phone
(562) 866-1895
Fax
(562) 866-5730
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Mukund V Deshmukh, MDNPI 1205930377
Title
Provider/Owner
Phone
(714) 401-4127

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X A051789 CA Primary

Addresses

Primary practice location

6143 E Cliffway Dr
Orange, CA 92869

Mailing address

39702 Kucera CT
Murrieta, CA 92563-5402
Phone (951) 677-0044

Other identifiers 2

IdentifierTypeStateIssuer
00A517891OtherCABLUE SHIELD
00A517890MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140516000287 CA Part B Supplier - Clinic/Group Practice 0345463592 Receives reassigned benefits from 1 practitioner
Practice locations: Chino, CA; Riverside, CA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1508967381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39702 KUCERA CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925635402",
            "telephone_number": "951-677-0044",
            "fax_number": "951-677-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 E CLIFFWAY DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92869",
            "telephone_number": "562-866-1895",
            "fax_number": "562-866-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUKUND DESHMUKH MD INC APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "DESHMUKH",
        "authorized_official_first_name": "MUKUND",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "714-401-4127",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A051789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A517891",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A517890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.