Benali Girish Deshpande, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-112326 Issued in IL

Practice address

420 NE Glen Oak Ave
Suite 201
Peoria, IL 61603-3105

Phone

(888) 627-5673

Fax

(309) 683-5969

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1841489929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "address_2": "SUITE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "888-627-5673",
            "fax_number": "309-683-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "address_2": "SUITE 201",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "888-627-5673",
            "fax_number": "309-683-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHPANDE",
        "first_name": "BENALI",
        "middle_name": "GIRISH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-112326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "809840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danea Deppert
• Kristin M Derer, CRNA
• Tenzin Desa, M.D.
• Ansh Desai, MD
• Chaitanya Rajendra Desai, M.D.
• Girish Ganesh Deshpande, MD
• Desired Medical Services 2 LLC
• Kelly Desmarais, APRN
• Terri M Desmond, SPEECH THERAPIST
• Melissa A Dessert, LCPC/CADC

• Pediatrics Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.