NPIMap

Individual provider Active NPI

Ashley Marie Mulder, MD

  • Family Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1104455989
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
69006 Issued in AZ
Practice address
1851 Mesquite Ave Ste 202
Lake Havasu City, AZ 86403-5681
Phone
(928) 854-0094
Fax
(928) 680-8986
NPI assigned
Apr 3, 2020
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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 69006 AZ Primary

Addresses

Primary practice location

1851 Mesquite Ave Ste 202
Lake Havasu City, AZ 86403-5681

Mailing address

1851 Mesquite Ave Ste 202
Lake Havasu City, AZ 86403-5681
Phone (928) 854-0094

Other names 1

  • Ashley Marie Desmarais Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621001827 AZ Practitioner - Family Practice 0749648988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

285 Lake Havasu Ave S
Suite 100
Lake Havasu City, AZ 86403-0852
Phone (928) 208-4598

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.85 of 100Reported as group
Quality
60.31
Promoting interoperability
93
Improvement activities
40
Cost
78.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Raghav LLC CurrentSince Jun 23, 2025 Accepting new patients
Lakeside Heart and Vascular Center PLLC CurrentSince Jul 1, 2023 Accepting new patients
Prescott Healthcare Solutions LLC Family Medicine CurrentSince Jun 23, 2025 Accepting new patients

Locations

2500 Canyon Rd
Ste A1
Bullhead City, AZ 86442
Phone (928) 704-4499

285 Lake Havasu Ave S
Ste 100
Lake Havasu City, AZ 86403
Phone (928) 208-4598

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403
Phone (928) 453-1970

1810 Mesquite Ave
Ste A
Lk Havasu Cty, AZ 86403
Phone (520) 855-4224

1987 McCulloch Blvd N
Ste 101
Lk Havasu Cty, AZ 86403
Phone (904) 994-5560

2010 Injo Dr
Lk Havasu Cty, AZ 86403
Phone (623) 227-1000

2035 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 208-4598

2082 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 453-2828

3151 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 458-7583

Interoperability endpoints

  • Direct secure messaging: ashley.desmarais.1@3291.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3291/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1104455989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MESQUITE AVE STE 202",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035681",
            "telephone_number": "928-854-0094",
            "fax_number": "928-680-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MESQUITE AVE STE 202",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035681",
            "telephone_number": "928-854-0094",
            "fax_number": "928-680-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "69006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "DESMARAIS",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.