Individual provider Active NPI

Christa Desrosiers

  • Social Worker
  • Miami, FL
National Provider Identifier
1154885101
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
15885 Issued in FL
Practice address
3180 Biscayne Blvd
Miami, FL 33137-4127
Phone
(786) 738-1011
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW20808 AZ
Social Worker 104100000X 15885 FL Primary

Addresses

Primary practice location

3180 Biscayne Blvd
Miami, FL 33137-4127

Mailing address

1684 SE 23Rd LN
Homestead, FL 33035-1251
Phone (786) 738-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190222000225 FL Practitioner - Clinical Social Worker 2264771096 Reassigns benefits to 1 organization
I20221121001496 AZ Practitioner - Clinical Social Worker 2264771096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

6601 W Thomas Rd
Phoenix, AZ 85033-5700
Phone (602) 243-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15885FLMDSocial Worker
LCSW20808AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of South Florida, Inc CurrentSince Feb 8, 2019 Accepting new patients
Community Health of South Florida Inc CurrentSince Feb 8, 2019 Accepting new patients
Mountain Park Health Center CurrentSince Nov 28, 2022 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Nov 28, 2022 Accepting new patients

Locations

6601 W Thomas Rd
Phoenix, AZ 85033

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

3830 E Van Buren St
Phoenix, AZ 85008
Phone (602) 806-6655

635 E Baseline Rd
Phoenix, AZ 85042

10300 SW 216th St
Cutler Bay, FL 33190

Organizations & group practices 5

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1154885101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 SE 23RD LN",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351251",
            "telephone_number": "786-738-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331374127",
            "telephone_number": "786-738-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESROSIERS",
        "first_name": "CHRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW20808",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "15885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.