NPIMap

Individual provider Active NPI

Sunita M Deshmukh, MD

  • Internal Medicine Physician
  • Gresham, OR
National Provider Identifier
1730133679
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD23064 Issued in OR
Practice address
440 NW Division St
Gresham, OR 97030-5506
Phone
(503) 215-9500
Fax
(503) 215-9525
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD23064 OR Primary

Addresses

Primary practice location

440 NW Division St
Gresham, OR 97030-5506

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
287131MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000713 OR Practitioner - Internal Medicine 0446384838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

440 NW Division St
Gresham, OR 97030-5506
Phone (503) 215-9500

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

  • Providence Home Health Home health agency, Portland, OR, CCN 387048
  • Assured Home Health Home health agency, Clackamas, OR, CCN 387127
  • Providence Hospice Hospice, Portland, OR, CCN 381500
  • Bristol Hospice Oregon LLC Hospice, Clackamas, OR, CCN 381559
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23064ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jan 20, 2002 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jan 20, 2002 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Past Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015
Phone (503) 215-2110

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

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.

Hospital & facility affiliations 10

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1730133679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305506",
            "telephone_number": "503-215-9500",
            "fax_number": "503-215-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHMUKH",
        "first_name": "SUNITA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287131",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.