Individual provider Active NPI

Deepa Pawar, M.D.

  • Psychiatry Physician
  • Milwaukee, WI
National Provider Identifier
1528200615
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
60977-20 Issued in WI
Practice address
1155 N Mayfair Rd
Milwaukee, WI 53226-3462
Phone
(414) 955-8990
Fax
(414) 955-6299
NPI assigned
Apr 3, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 60977-20 WI
Psychiatry Physician 2084P0800X 60977-20 WI Primary

Addresses

Primary practice location

1155 N Mayfair Rd
Milwaukee, WI 53226-3462

Mailing address

1155 N Mayfair Rd
Milwaukee, WI 53226-3462
Phone (414) 955-8990

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-8990

Other practice location 2

840 N 87th St
Milwaukee, WI 53226-3586
Phone (414) 805-5540

Other identifiers 1

IdentifierTypeStateIssuer
1528200615MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160602000168 WI Practitioner - PsychiatryPractitioner - General Practice 1557680170 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528200615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-8990",
            "fax_number": "414-955-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-8990",
            "fax_number": "414-955-6299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-955-8990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 N 87th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263586",
            "country_code": "US",
            "telephone_number": "414-805-5540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAWAR",
        "first_name": "DEEPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "WI",
            "license": "60977-20",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "60977-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528200615",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.