Active NPI
Deepak Prabhakar, MD
- Child & Adolescent Psychiatry Physician
- Detroit, MI
National Provider Identifier
1952565764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 4301092111
- Practice address
- 1 Ford PL
Detroit, MI 48202-3450 - Phone
- (800) 653-6568
- NPI assigned
- Jul 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301092111 | MI | |
| Psychiatry Physician | 2084P0800X | D0086538 | MD | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 4301092111 | MI | Primary |
Addresses
Primary practice location
1 Ford PL
Detroit, MI 48202-3450
Mailing address
1 Ford PL
Detroit, MI 48202-3450
Phone (800) 653-6568
Other practice location 1
6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0086538 | MD | MD | Psychiatry Physician |
| 4301092111 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients |
Locations
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
Interoperability endpoints
- dprabhakar195161@direct.hfhs.org
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1952565764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "800-653-6568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 FORD PL",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "800-653-6568"
}
],
"practiceLocations": [
{
"address_1": "6501 N Charles St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212046819",
"country_code": "US",
"telephone_number": "410-938-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRABHAKAR",
"first_name": "DEEPAK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-11",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301092111",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0086538",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MI",
"license": "4301092111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.