Active NPI
Stephanie D. Desandro, P.A.
- Physician Assistant
- Houston, TX
National Provider Identifier
1023042900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA03686
- Practice address
- 5656 Kelley St
Houston, TX 77026-1967 - Phone
- (713) 566-5775
- Fax
- (713) 566-5024
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA03686 | TX | |
| Physician Assistant | 363A00000X | PA03686 | TX | Primary |
Addresses
Primary practice location
5656 Kelley St
Houston, TX 77026-1967
Mailing address
PO Box 301173
Dallas, TX 75303-1173
Phone (713) 500-3500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181497201 | Medicaid | TX | |
| 003182516 | Other | TX | CSHCN |
| 8N3838 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.11 of 100
- Quality
- 69.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.63
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA03686 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Physicians | Current | Accepting new patients | |
| Ut Physicians | Physician Assistant | Current | Accepting new patients |
Locations
5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000
6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714
6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200
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 and National Provider Directory roles.
-
- Health Educator
- Houston, TX
- NPI 1316534472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470009600000",
"number": "1023042900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 301173",
"city": "DALLAS",
"state": "TX",
"postal_code": "753031173",
"telephone_number": "713-500-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5656 KELLEY ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770261967",
"telephone_number": "713-566-5775",
"fax_number": "713-566-5024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANDRO",
"first_name": "STEPHANIE",
"middle_name": "D.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2016-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA03686",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA03686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181497201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "003182516",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8N3838",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.
- 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.