Mary Shirley Desormes, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008617-1 Issued in NY

Practice address

82-68 164 Street
Queens Hospital Center
Jamaica, NY 11432

Phone

(718) 658-5480

NPI assigned

Jul 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1962680454

  SC

  Medicare reassignment Care Compare group NPD
• American Current Care of North Carolina, P.C.

  • Health Service Clinic/Center
  • Addison, TX
  • NPI 1306015102

  NC

  Medicare reassignment
• American Current Care P.a.

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1063641009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7207 AVALON DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064847618",
            "telephone_number": "917-576-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-68 164 STREET",
            "address_2": "QUEENS HOSPITAL CENTER",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-658-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESORMES",
        "first_name": "MARY",
        "middle_name": "SHIRLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Desai, M.D.
• Zankhana Desai, RPH
• Rosa Deshazo
• Designer Optical of Jamaica
• Motunde Desina
• Simone Desouza, PHYSICAL THERAPIST
• Jennifer Therese Despeine, LMFT
• Danielle Rose Marie Desravines
• Gladys Desroches
• Chris Allen Desrosin, PA-C

• Physician Assistant in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.

Verify at the official NPI Registry.