Individual provider Active NPI

Shivani Narendra Desai, PA-C

  • Physician Assistant
  • New Haven, CT
National Provider Identifier
1144243825
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001479 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-2318
NPI assigned
Jul 25, 2006
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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 001479 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

361 Annelise Ave
Southington, CT 06489-2065
Phone (860) 620-9337

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-8950

Other names 1

  • Ms. Shivani N Khariwala Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sdesai14481@direct.connecticutchildrens.org
Direct Messaging Address sdesai14481@direct.connecticutchildrens.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20070221000184 CT Practitioner - Physician Assistant 8820190978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001479CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 16, 2023 Accepting new patients
Yale University CurrentSince May 16, 2023 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Physician Assistant Past Accepting new patients
Saint Raphael Faculty Physicians Physician Assistant Past Accepting new patients

Locations

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Interoperability endpoints

  • Direct secure messaging: sdesai3603@direct.ynhh.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1144243825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 ANNELISE AVE",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892065",
            "telephone_number": "860-620-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-545-8950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESAI",
        "first_name": "SHIVANI",
        "middle_name": "NARENDRA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdesai14481@direct.connecticutchildrens.org",
            "affiliation": "N",
            "address_1": "20 York St",
            "city": "New Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065103220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdesai14481@direct.connecticutchildrens.org",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHIVANI",
            "last_name": "KHARIWALA",
            "middle_name": "N",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.