Active NPI
Poornima Deshmukh, M.D.
- Anesthesiology Physician
- Freehold, NJ
National Provider Identifier
1609821776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MA07686500
- Practice address
- 901 W Main St
Freehold, NJ 07728-2537 - Phone
- (732) 294-2875
- NPI assigned
- May 24, 2006
- Last updated
- Nov 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA07686500 | NJ | Primary |
| Specialist | 174400000X | 25MA07686500 | NJ |
Addresses
Primary practice location
901 W Main St
Freehold, NJ 07728-2537
Mailing address
901 W Main St
Freehold, NJ 07728-2537
Phone (732) 294-2875
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00404428 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
901 W Main St
Freehold, NJ 07728-2537
Phone (732) 431-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA07686500 | NJ | MD | Anesthesiology Physician |
Interoperability endpoints
- pdeshmukh425072@direct.ahsys.org
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.
-
- Anesthesiology Physician
- Hackensack, NJ
- NPI 1174585780
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Freehold, NJ
- NPI 1295718450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1609821776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 W MAIN ST",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077282537",
"telephone_number": "732-294-2875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W MAIN ST",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077282537",
"telephone_number": "732-294-2875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESHMUKH",
"first_name": "POORNIMA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA07686500",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA07686500",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00404428",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Freehold, NJ
- Alicia Raquel Dermer, MD
- Dermone Dermatology Associates of the Garden State, PC
- Rajen Uday Desai, M.D.
- Alexandria Noelle Desalvatore, OTR
- Eugene L Desalvo, MD
- Alix Detullio, APN
- John P Detullio, M.D., F.C.C.P.
- Development 4 Individuals With Disability
- Devereux NJ Reach Treatment Home
- Rachel Devincenzo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.