Individual provider Active NPI

Krishna B Deshpande, MD

  • Interventional Pain Medicine Physician
  • Dublin, OH
National Provider Identifier
1730100413
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
35041372 Issued in OH
Practice address
4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551
Phone
(937) 707-4662
Fax
(614) 573-0530
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35-041372 OH
Interventional Pain Medicine Physician 208VP0014X 35041372 OH Primary

Addresses

Primary practice location

4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551

Mailing address

4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551
Phone (937) 707-4662

Other identifiers 1

IdentifierTypeStateIssuer
0363753MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060918000294 OH Practitioner - Osteopathic Manipulative MedicinePractitioner - General Surgery 0345245734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbus Physicians Group LLCGroup PAC ID 9234589409, 4 clinicians

Practice addresses (Care Compare)

4995 Bradenton Ave
Dublin, OH 43017-3551

6189 Memorial Dr
Dublin, OH 43017-9000
Phone (614) 515-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-041372OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North East Ohio Group Practice LLC CurrentSince Feb 20, 2003 Accepting new patients
Columbus Physicians Group LLC Interventional Pain Medicine CurrentSince Oct 1, 2023 Accepting new patients
Physical Medicine & Rehabilitation Centers of Ohio Current Accepting new patients
Orthopaedic & Spine Center at Polaris, LLC Past Accepting new patients

Locations

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

6189 Memorial Dr
Dublin, OH 43017
Phone (614) 515-2500

4995 Bradenton Ave
Ste 110
Dublin, OH 43017
Phone (614) 515-2500

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Organizations & group practices 4

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1730100413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 110",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "937-707-4662",
            "fax_number": "614-573-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 110",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "937-707-4662",
            "fax_number": "614-573-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHPANDE",
        "first_name": "KRISHNA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35-041372",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OH",
            "license": "35041372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363753",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.