Desara Preducaj, DNP, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704351329 Issued in MI

Practice address

35284 23 Mile Rd
New Baltimore, MI 48047-2096

Phone

(586) 335-3573

NPI assigned

Feb 13, 2023

Last updated

Jan 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Desara Uldedaj Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Health Urgent Care PLLCGroup PAC ID 7012432396, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Advance Health Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Clinton TWP, MI
  • NPI 1124841127
  Medicare reassignment Care Compare group NPD
• Blue Water Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Fort Gratiot, MI
  • NPI 1477135036
  Medicare reassignment NPD
• Endocrine Shores PC

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1780943266
  Medicare reassignment NPD
• Blue Water Urgent Care New Baltimore

  • Urgent Care Clinic/Center
  • New Baltimore, MI
  • NPI 1235841362
  NPD

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1457058273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35284 23 MILE RD",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480472096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35284 23 MILE RD",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480472096",
            "telephone_number": "586-335-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDUCAJ",
        "first_name": "DESARA",
        "credential": "DNP, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704351329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2022090598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESARA",
            "last_name": "ULDEDAJ",
            "credential": "DNP, RN, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PHC of Michigan LLC (Harbor Oaks Hospital)
• PHC of Michigan, LLC (Harbor Oaks Hospital)
• PHC of Michigan, LLC (Harbor Oaks Hospital)
• Joseph J Powers, D.D.S.
• Zsuzsanna Pozar, LMT
• Rare Mind and Body
• Rebecca Sue Rea, D.O.
• Rite Aid of Michigan Inc (Rite Aid Pharmacy 04833)
• Karen M Robinson
• Dia Salazar

• Family Nurse Practitioner in New Baltimore, MI
• Providers in New Baltimore, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2025; 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.