Individual provider Active NPI

Varun Kumar Deshpande, PT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1861764789
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034679 Issued in NY
Practice address
4161 Kissena Blvd
Suite 6
Flushing, NY 11355-3181
Phone
(718) 463-6335
Fax
(718) 463-6087
NPI assigned
Feb 8, 2012
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 034679 NY Primary

Addresses

Primary practice location

4161 Kissena Blvd
Suite 6
Flushing, NY 11355-3181

Mailing address

41-61 Kissena Blvd.
Suite 6
Flushing, NY 11355-3181
Phone (718) 463-6335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000230 NY Practitioner - Physical Therapist in Private Practice 0941469217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TLC Rehabilitation Physical Therapy PCGroup PAC ID 5698667434, 4 clinicians

Practice addresses (Care Compare)

4161 Kissena Blvd
Suite 6
Flushing, NY 11355-3105

6501 Bay Pkwy
Brooklyn, NY 11204-3948
Phone (718) 238-9392

6501 Bay Pkwy C Level
Brooklyn, NY 11204-3948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Clove Lake Physical Therapy PC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1861764789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41-61 KISSENA BLVD.",
            "address_2": "SUITE 6",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553181",
            "telephone_number": "718-463-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD",
            "address_2": "SUITE 6",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553181",
            "telephone_number": "718-463-6335",
            "fax_number": "718-463-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHPANDE",
        "first_name": "VARUN",
        "middle_name": "KUMAR",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.