Individual provider Active NPI

Deep Sharma, M.D.

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1578759338
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
266341 Issued in NY
Practice address
3411 Wayne Ave
5TH Floor
Bronx, NY 10467-2509
Phone
(866) 633-8255
Fax
(718) 652-8384
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 266341 NY Primary

Addresses

Primary practice location

3411 Wayne Ave
5TH Floor
Bronx, NY 10467-2509

Mailing address

3411 Wayne Ave
5TH Floor
Bronx, NY 10467-2509
Phone (866) 633-8255

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
I20121027000025 NY Practitioner - Nephrology 3476607482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University College of Medicine, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266341NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Nephrology CurrentSince Sep 1, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Sep 1, 2012 Accepting new patients
The Good Samaritan Hospital of Maryland, Inc. Past Accepting new patients
Medstar Good Samaritan Physicians LLC Past Accepting new patients

Locations

1180 Morris Park Ave
Bronx, NY 10461
Phone (718) 829-1500

3411 Wayne Ave
Apt 5H
Bronx, NY 10467

3411 Wayne Ave
Fl 5
Bronx, NY 10467

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

111 E 210th St
Bronx, NY 10467

Networks

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

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 2

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1578759338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "866-633-8255",
            "fax_number": "718-652-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 WAYNE AVE",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672509",
            "telephone_number": "866-633-8255",
            "fax_number": "718-652-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "DEEP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "266341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.