Individual provider Active NPI

Devyani N Desai, MD

  • Psychiatry Physician
  • Lakeland, FL
National Provider Identifier
1558354175
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME54873 Issued in FL
Practice address
1835 Gilmore Ave
Lakeland, FL 33805-3017
Phone
(863) 248-3300
Fax
(863) 413-3083
NPI assigned
Aug 30, 2005
Last updated
May 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301047811 MI
Psychiatry Physician 2084P0800X ME54873 FL Primary

Addresses

Primary practice location

1835 Gilmore Ave
Lakeland, FL 33805-3017

Mailing address

320 Debuel Rd
Lutz, FL 33549-5444
Phone (813) 404-7980

Other identifiers 3

IdentifierTypeStateIssuer
057537200MedicaidFL
14238OtherFLBLUE CROSS BLUE SHIELD
1558354175MedicaidMI

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141215001792 MI Practitioner - Psychiatry 2466414545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Psychiatry CurrentSince Nov 13, 2014 Accepting new patients
Community Mental Health for Central Michigan Psychiatry PastSince Nov 24, 2019 Accepting new patients

Locations

301 S Crapo St
Ste 100
Mt Pleasant, MI 48858
Phone (989) 772-5938

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1558354175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DEBUEL RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335495444",
            "telephone_number": "813-404-7980",
            "fax_number": "863-413-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 GILMORE AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053017",
            "telephone_number": "863-248-3300",
            "fax_number": "863-413-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "DEVYANI",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301047811",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME54873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057537200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14238",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558354175",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.