Active NPI
Deepti Sameer Mundkur, MBBS
- Internal Medicine Physician
- Ramona, CA
National Provider Identifier
1629431077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A158230
- Practice address
- 211 13TH St
Ramona, CA 92065-2711 - Phone
- (760) 789-5160
- NPI assigned
- Apr 2, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A158230 | CA | Primary |
Addresses
Primary practice location
211 13TH St
Ramona, CA 92065-2711
Mailing address
15611 Pomerado Rd Ste 400
Poway, CA 92064-2437
Phone (858) 675-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A158230 | Other | CA | CA MED LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Aug 15, 2020 through Aug 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A158230 | CA | MD | Internal Medicine Physician |
Interoperability endpoints
- deepti.mundkur.p1@direct.arch.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1629431077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15611 POMERADO RD STE 400",
"city": "POWAY",
"state": "CA",
"postal_code": "920642437",
"telephone_number": "858-675-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 13TH ST",
"city": "RAMONA",
"state": "CA",
"postal_code": "920652711",
"telephone_number": "760-789-5160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNDKUR",
"first_name": "DEEPTI",
"middle_name": "SAMEER",
"credential": "MBBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-02",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A158230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA MED LICENSE",
"identifier": "A158230",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ramona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.