Active NPI
Ashley Ruth Shelsie Desameau, PA-C
- Physician Assistant
- Longmeadow, MA
National Provider Identifier
1114768207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA102859
- Practice address
- 588 Longmeadow St
Longmeadow, MA 01106-2212 - Phone
- (413) 565-1000
- NPI assigned
- Jun 4, 2024
- 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 | PA102859 | MA | Primary |
Addresses
Primary practice location
588 Longmeadow St
Longmeadow, MA 01106-2212
Mailing address
960 Massachusetts Avenue
FL 2
Boston, MA 02118
Other practice location 1
11 Nevins St
Ste 505
Brighton, MA 02135
Phone (617) 414-2580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110238068A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1114768207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVENUE",
"address_2": "FL 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "588 LONGMEADOW ST",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011062212",
"telephone_number": "413-565-1000"
}
],
"practiceLocations": [
{
"address_1": "11 Nevins St",
"address_2": "Ste 505",
"address_purpose": "LOCATION",
"city": "Brighton",
"state": "MA",
"postal_code": "02135",
"country_code": "US",
"telephone_number": "617-414-2580",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESAMEAU",
"first_name": "ASHLEY",
"middle_name": "RUTH SHELSIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA102859",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110238068A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.