Individual provider Active NPI

Deepika Ika Baren, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1649762485
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(919) 413-2018
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

3946 27TH St Apt 1B
Long Island City, NY 11101-3836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906001717 MA Practitioner - Physician Assistant 3971966169 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Umass Memorial Medical Group Inc Multi-Specialty CurrentSince Jul 23, 2023 Accepting new patients
Umass Memorial Medical Center, Inc Multi-Specialty CurrentSince Jul 23, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. Multi-Specialty CurrentSince Jul 23, 2023 Accepting new patients

Locations

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1649762485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3946 27TH ST APT 1B",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "919-413-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAREN",
        "first_name": "DEEPIKA",
        "middle_name": "IKA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.