Individual provider Active NPI

Danielle Rosner Desa, D.O.

  • Rheumatology Physician
  • Gainesville, FL
National Provider Identifier
1366861874
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
UO3980 Issued in FL
Practice address
4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone
(352) 378-5173
Fax
(352) 375-2330
NPI assigned
Apr 11, 2014
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO3980 FL
Rheumatology Physician 207RR0500X UO3980 FL Primary

Addresses

Primary practice location

4343 W Newberry Rd
Gainesville, FL 32607-2817

Mailing address

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 416-1082

Other identifiers 1

IdentifierTypeStateIssuer
103472400MedicaidFL

Other names 1

  • Danielle Rosner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729001056 FL Practitioner - Rheumatology 3274759139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Simed Health LLC CurrentSince Sep 1, 2019 Accepting new patients
Simedhealth LLC Rheumatology CurrentSince Sep 1, 2019 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

Organizations & group practices 2

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": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1366861874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-416-1082",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072817",
            "telephone_number": "352-378-5173",
            "fax_number": "352-375-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESA",
        "first_name": "DANIELLE",
        "middle_name": "ROSNER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO3980",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "UO3980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103472400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "ROSNER",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.