Individual provider Active NPI

Deepak G. Pradhan, M.D.

  • Radiation Oncology Physician
  • Detroit, MI
National Provider Identifier
1720148133
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
065057 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-9106
Fax
(313) 916-1249
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 065057 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-9106

Other identifiers 2

IdentifierTypeStateIssuer
DP065057OtherCHAMPUS-CHAMPUS
DP065057OtherCOMMERCIAL-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040211001068 MI Practitioner - Radiation Oncology 7416841242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1102 E Michigan Ave
Jackson, MI 49201-1802
Phone (517) 205-7299

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
065057MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jan 18, 2023 Accepting new patients
Henry Ford Health System Current Accepting new patients
W a Foote Memorial Hospital Inc Radiation Oncology CurrentSince Jan 18, 2023 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2000 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2000 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

19675 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-3311

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

2800 W Grand Blvd
Detroit, MI 48202
Phone (313) 230-1078

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

1102 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7299

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: dpradhan13068@direct.hfhs.org

Organizations & group practices 9

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 3

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720148133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-9106",
            "fax_number": "313-916-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADHAN",
        "first_name": "DEEPAK",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "065057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "DP065057",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "DP065057",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.