Nisha Deshpande, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8366-23 Issued in WI

Practice address

3400 Market LN Ste 300
Kenosha, WI 53144-3430

Phone

(262) 551-4600

Fax

(262) 551-4630

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ndeshpande952868@direct.froedtert.com
• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

• Froedtert South, Inc.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1558305284
  Medicare reassignment Care Compare group NPD
• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  Medicare reassignment NPD
• App of Illinois Ed PLLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1053860080
  Medicare reassignment
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  NPD (past)
• Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Elgin, IL
  • NPI 1447381074
  NPD (past)
• Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1750275640
  NPD (past)

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

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1154322147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE STE 105",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-577-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MARKET LN STE 300",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443430",
            "telephone_number": "262-551-4600",
            "fax_number": "262-551-4630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Summit St",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601203843",
            "country_code": "US",
            "telephone_number": "847-608-1344 x222",
            "fax_number": "847-608-0672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESHPANDE",
        "first_name": "NISHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8366-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental 360 Kenosha
• Dental Care Providers of America
• Virginia L Denton, SLP
• Mark John Derbas, LPC
• Amanda Derose, MCEP, DPT
• Jami J Detjens, B.S.
• Megan Elizabeth Devictoria, L.P.N.
• Kulwant Singh Dhaliwal, MD
• Stephani Diagne
• Alwin A Diaz, N.P.

• Physician Assistant in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.