Individual provider Active NPI

Pooja Mehulkumar Desai, PA-C

  • Physician Assistant
  • Long Island City, NY
National Provider Identifier
1104795152
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034846 Issued in NY
Practice address
2715 30TH Ave
Long Island City, NY 11102-2445
Phone
(718) 685-2300
NPI assigned
Oct 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 034846 NY Primary

Addresses

Primary practice location

2715 30TH Ave
Long Island City, NY 11102-2445

Mailing address

2715 30TH Ave
Long Island City, NY 11102-2445
Phone (215) 904-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251125004774 NY Practitioner - Physician Assistant 8628560737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Josef Schenker MD PCGroup PAC ID 8022335330, 57 clinicians

Practice addresses (Care Compare)

1811 Ave J
Brooklyn, NY 11230-3808
Phone (718) 534-0689

4426 18TH Ave
Brooklyn, NY 11204-1201
Phone (718) 635-9700

6122 Fresh Pond Rd
Middle Village, NY 11379-1040
Phone (718) 502-3000

6402 108TH St
Forest Hills, NY 11375-1604
Phone (212) 734-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034846NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Josef Schenker MD PC CurrentSince Sep 15, 2025 Accepting new patients

Locations

4426 18th Ave
Brooklyn, NY 11204
Phone (718) 635-9700

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

6122 Fresh Pond Rd
Middle Vlg, NY 11379
Phone (718) 502-3000

Organizations & group practices 1

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": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1104795152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022445",
            "telephone_number": "215-904-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022445",
            "telephone_number": "718-685-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "POOJA",
        "middle_name": "MEHULKUMAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.