Active NPI
Alyssa Desmarais, PA-C
- Physician Assistant
- Springfield, MA
National Provider Identifier
1043736739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1142951
- Practice address
- 3455 Main St Ste 5
Springfield, MA 01107-1147 - Phone
- (413) 733-9600
- NPI assigned
- Aug 15, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1142951 | MA | Primary |
Addresses
Primary practice location
3455 Main St Ste 5
Springfield, MA 01107-1147
Mailing address
96 Wildflower Cir
Westfield, MA 01085-4590
Phone (413) 454-1182
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1142951 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1043736739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 WILDFLOWER CIR",
"city": "WESTFIELD",
"state": "MA",
"postal_code": "010854590",
"telephone_number": "413-454-1182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 MAIN ST STE 5",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071147",
"telephone_number": "413-733-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESMARAIS",
"first_name": "ALYSSA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "1142951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.