Deepti Kallam, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

35C000445 Issued in OH

Practice address

3107 W Camp Wisdom Rd Ste 110
Dallas, TX 75237-2600

Phone

(214) 765-2222

Fax

(214) 269-9902

NPI assigned

Aug 9, 2013

Last updated

Jul 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Bala Deepti Gangireddy Former name

Medicare fee-for-service enrollment

Enrolled in LA, OH, NE3 enrollments

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 3

Specialty

Hematology/Oncology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regional West Physicians ClinicGroup PAC ID 2062301609, 136 clinicians

Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
• Regional West Medical Center Hospital, Scottsbluff, NE, CCN 280061
• Community Hospital Hospital, Torrington, WY, CCN 531307
• Box Butte General Hospital Hospital, Alliance, NE, CCN 281360
• Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkallam1698146@direct.bsmhealth.org

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.

• Mercy Health Physicians Lima Specialty Care LLC

  • Surgery Physician
  • Lima, OH
  • NPI 1518589803

  Hospitalist

  Medicare reassignment Care Compare group NPD
• Regional West Physicians Clinic

  • Family Medicine Physician
  • Scottsbluff, NE
  • NPI 1306910534
  Medicare reassignment Care Compare group
• Hospitalist Medicine Physicians of Texas, PLLC

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1629307095

  LA

  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Box Butte General Hospital

  • Critical Access Hospital
  • Alliance, NE
  • NPI 1811929060
  Care Compare affiliation
• Community Hospital

  • Critical Access Hospital
  • Torrington, WY
  • NPI 1669410643
  Care Compare affiliation
• Mary Rutan Hospital

  • General Acute Care Hospital
  • Bellefontaine, OH
  • NPI 1548254931
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  dba Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Lima, OH
  • NPI 1447276936
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  dba Mercy Health-St Rita's Medical Center

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1811939887
  Care Compare affiliation
• Regional West Medical Center

  • General Acute Care Hospital
  • Scottsbluff, NE
  • NPI 1639101199
  Care Compare affiliation

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1609209949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 W CAMP WISDOM RD STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372600",
            "telephone_number": "214-765-2222",
            "fax_number": "214-269-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 W CAMP WISDOM RD STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372600",
            "telephone_number": "214-765-2222",
            "fax_number": "214-269-9902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Main St Ste 380",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750573606",
            "country_code": "US",
            "telephone_number": "214-379-2700",
            "fax_number": "972-869-3875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-813-2528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7415 Las Colinas Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750637569",
            "country_code": "US",
            "telephone_number": "214-379-2700",
            "fax_number": "972-869-3875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "431 E State Highway 114 Ste 470",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760924415",
            "country_code": "US",
            "telephone_number": "214-379-2700",
            "fax_number": "972-869-3875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 W Henderson St Ste A",
            "address_purpose": "LOCATION",
            "city": "Cleburne",
            "state": "TX",
            "postal_code": "760335117",
            "country_code": "US",
            "telephone_number": "682-244-6688",
            "fax_number": "817-820-0698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10647 Canoe Dr",
            "address_purpose": "LOCATION",
            "city": "Coppell",
            "state": "TX",
            "postal_code": "750195894",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLAM",
        "first_name": "DEEPTI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "S1620",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "S1620",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OH",
            "license": "35C00445",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35C000445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200122442",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BALA DEEPTI",
            "last_name": "GANGIREDDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lyle A Kaliser, M.D.
• Sophia Kalish, COTA
• Gokhan Kalkan, MD
• Nitin Kalla
• Ajay Shubhadeep Kallam, MD
• Diya Kallam
• Justine Kallaugher, PHD
• Barbara Lynn Kallenbach-Watson, CNP
• Rohini Kallianpur
• Selmi Kallmi, PHD

• Hematology & Oncology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Hematology & Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.