Michelle Beatrice Deshazer, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-09944 Issued in NC

Practice address

1450 Professional Park Dr Ste 150
Winston Salem, NC 27103-1307

Phone

(336) 724-2434

Fax

(336) 607-8061

NPI assigned

Aug 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michelle B Schoenlein, Gaskin Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Saint Louis University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TLK Dermatology PLLCGroup PAC ID 6608313440, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: mgaskin@directaddress.net

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.

• TLK Dermatology PLLC

  • Dermatology Physician
  • Asheboro, NC
  • NPI 1780453464
  Medicare reassignment Care Compare group
• Francis C Lee, MD SC

  • Dermatology Physician
  • Decatur, IL
  • NPI 1669687984
  NPD (past)

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1295013795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 PROFESSIONAL PARK DR STE 150",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031307",
            "telephone_number": "336-724-2434",
            "fax_number": "336-607-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 PROFESSIONAL PARK DR STE 150",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031307",
            "telephone_number": "336-724-2434",
            "fax_number": "336-607-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHAZER",
        "first_name": "MICHELLE",
        "middle_name": "BEATRICE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-793",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "SCHOENLEIN, GASKIN",
            "middle_name": "B",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deval I Desai, OD
• Dhyey Desai
• John Martin Desalvo III, LMBT
• Shayna Lee Desando, DO
• Priscilla Desangles Jose
• Poonam Deshmukh, M.D
• Noelle Annette Desimone, MD
• Brent W Deskins, LMBT
• Naucika Maria Desouza
• Elizabeth C Deterding, MD

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.