Individual provider Active NPI

Andrew Deak, M.D.

  • Gastroenterology Physician
  • Cincinnati, OH
National Provider Identifier
1922002476
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35-035423 Issued in OH
Practice address
3652 Werk Rd
Cincinnati, OH 45248-4900
Phone
(513) 233-4100
Fax
(513) 751-2267
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35-035423 OH Primary

Addresses

Primary practice location

3652 Werk Rd
Cincinnati, OH 45248-4900

Mailing address

PO Box 632958
Cincinnati, OH 45263-2958
Phone (513) 451-9698

Other identifiers 2

IdentifierTypeStateIssuer
100010951OtherOHRAILROAD MEDICARE
0363940MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-035423OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Cincinnati Digestive Health Network Gastroenterology CurrentSince Oct 1, 2007 Accepting new patients

Locations

3652 Werk Rd
Cincinnati, OH 45248
Phone (513) 233-4100

3648 Werk Rd
Cincinnati, OH 45248
Phone (513) 233-4100

100 Arrow Springs Blvd
#200
Lebanon, OH 45036
Phone (513) 231-9010

Organizations & group practices 1

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1922002476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632958",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632958",
            "telephone_number": "513-451-9698",
            "fax_number": "513-451-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 WERK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452484900",
            "telephone_number": "513-233-4100",
            "fax_number": "513-751-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAK",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35-035423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100010951",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363940",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.