Individual provider Active NPI

Madhukar C Desai, MD

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1063484574
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G0394 Issued in TX
Practice address
11888 Marsh LN
#104
Dallas, TX 75234-8083
Phone
(972) 488-9222
Fax
(972) 488-0625
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G0394 TX Primary

Addresses

Primary practice location

11888 Marsh LN
#104
Dallas, TX 75234-8083

Mailing address

11910 Greenville Ave
Dallas, TX 75243-3596
Phone (214) 572-1124

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
G0394TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1063484574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11888 MARSH LN",
            "address_2": "#104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752348083",
            "telephone_number": "972-488-9222",
            "fax_number": "972-488-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "MADHUKAR",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G0394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.