Individual provider Active NPI

Roshni Sudhir Desai, PA-C

  • Physician Assistant
  • Sterling Heights, MI
National Provider Identifier
1215776430
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031485 Issued in NY
Practice address
43698 Vintners Place Dr
Sterling Heights, MI 48314-1333
Phone
(586) 506-0544
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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 031485 NY Primary

Addresses

Primary practice location

43698 Vintners Place Dr
Sterling Heights, MI 48314-1333

Mailing address

43698 Vintners Place Dr
Sterling Heights, MI 48314-1333
Phone (586) 506-0544

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
I20240531003501 NY Practitioner - Physician Assistant 5496197782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

27111 76TH Ave
New Hyde Park, NY 11040-1436
Phone (718) 289-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031485NYMDOrthodontics and Dentofacial Orthopedic Dentist

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1215776430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43698 VINTNERS PLACE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141333",
            "telephone_number": "586-506-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43698 VINTNERS PLACE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141333",
            "telephone_number": "586-506-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "ROSHNI",
        "middle_name": "SUDHIR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.