Individual provider Active NPI

Dhananjay S Deoskar, MD, FAAP

  • Pediatrics Physician
  • Richmond, TX
National Provider Identifier
1861696262
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P8461 Issued in TX
Practice address
7103 S Peek Rd Unit E3
Richmond, TX 77407-3498
Phone
(618) 549-0721
NPI assigned
Jun 12, 2007
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P8461 TX Primary
Pediatrics Physician 208000000X P8461 IL
Neonatal-Perinatal Medicine Physician 2080N0001X 10828 ND
Neonatal-Perinatal Medicine Physician 2080N0001X 036148243 IL
Pediatrics Physician 208000000X 57011356 OH

Addresses

Primary practice location

7103 S Peek Rd Unit E3
Richmond, TX 77407-3498

Mailing address

17514 Galloway Forest Dr
Richmond, TX 77407-1952
Phone (216) 466-2063

Other practice location 1

7103 S Peek Rd Unit E3
Richmond, TX 77407-3498
Phone (346) 620-6850

Other practice location 2

17500 W Grand Pkwy S
Sugar Land, TX 77479-2562
Phone (281) 725-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150601002510 TX Practitioner - Pediatric Medicine 9436222833 Reassigns benefits to 4 organizations
I20211220001098 IL Practitioner - Pediatric MedicinePractitioner - Other (Physician) 9436222833 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P8461ILMDPediatrics Physician
57011356OHMDPediatrics Physician
P8461TXMDPediatrics Physician
036148243ILMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Pediatrics PLLC Pediatrics CurrentSince Dec 16, 2023 Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Pediatrics CurrentSince Jul 4, 2017 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jan 3, 2022 Accepting new patients
Triad of Alabama LLC Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

7103 S Peek Rd
Bldg E
Richmond, TX 77407

7103 S Peek Rd
Unit 3
Richmond, TX 77407
Phone (216) 466-2063

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDAEDD/Endpoint/JDAEDD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1861696262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17514 GALLOWAY FOREST DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071952",
            "telephone_number": "216-466-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7103 S PEEK RD UNIT E3",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774073498",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7103 S Peek Rd Unit E3",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774073498",
            "country_code": "US",
            "telephone_number": "346-620-6850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17500 W Grand Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774792562",
            "country_code": "US",
            "telephone_number": "281-725-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEOSKAR",
        "first_name": "DHANANJAY",
        "middle_name": "S",
        "credential": "MD, FAAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P8461",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "P8461",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "ND",
            "license": "10828",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036148243",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57011356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.