NPIMap

Individual provider Active NPI

Rikesh Rajendra Desai, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Surprise, AZ
National Provider Identifier
1396966743
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
36199 Issued in AZ
Practice address
13921 W Grand Ave
Suite 502
Surprise, AZ 85374-2439
Phone
(623) 214-2200
Fax
(623) 214-2208
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 36199 AZ Primary

Addresses

Primary practice location

13921 W Grand Ave
Suite 502
Surprise, AZ 85374-2439

Mailing address

13921 W Grand Ave
Suite 502
Surprise, AZ 85374-2439
Phone (623) 214-2200

Other identifiers 1

IdentifierTypeStateIssuer
363867MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070925000038 AZ Practitioner - Family Practice 2466546247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westside Internal Medicine PCGroup PAC ID 4486634680, 2 clinicians

Practice addresses (Care Compare)

13640 N 99TH Ave
Suite 400
Sun City, AZ 85351-2867
Phone (623) 214-2200

14800 W Mountain View Blvd
Suite 180
Surprise, AZ 85374-2701
Phone (623) 214-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Hospice and Palliative Care LLC Family Medicine CurrentSince Oct 12, 2014 Accepting new patients

Locations

18185 N 83rd Ave
Ste 203
Glendale, AZ 85308
Phone (623) 566-7995

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEJFCA/Endpoint/FEJFCA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divine Hospice and Palliative Care LLCGlendale, AZ, CCN 031649 Hospice 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)		 Oct 12, 2014
Oct 12, 2014
Oct 12, 2014
Oct 12, 2014
Oct 12, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1396966743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13921 W GRAND AVE",
            "address_2": "SUITE 502",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742439",
            "telephone_number": "623-214-2200",
            "fax_number": "623-214-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13921 W GRAND AVE",
            "address_2": "SUITE 502",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742439",
            "telephone_number": "623-214-2200",
            "fax_number": "623-214-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "RIKESH",
        "middle_name": "RAJENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "36199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363867",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.