Jon Anthony Desmarais, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05006317A Issued in IN

Practice address

401 E Colfax Ave
Ste. 102
South Bend, IN 46617-2737

Phone

(574) 234-1059

Fax

(574) 234-1068

NPI assigned

Dec 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Rci (WRS), LLC.

  • Physical Therapy Clinic/Center
  • Mishawaka, IN
  • NPI 1619583044

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rci (WRS), LLC

  • Physical Therapy Clinic/Center
  • South Bend, IN
  • NPI 1821604240
  NPD
• Rci (WRS), LLC

  • Physical Therapy Clinic/Center
  • Mokena, IL
  • NPI 1568160950
  NPD

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1619953221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E COLFAX AVE",
            "address_2": "STE. 102",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172737",
            "telephone_number": "574-234-1059",
            "fax_number": "574-234-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E COLFAX AVE",
            "address_2": "STE. 102",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172737",
            "telephone_number": "574-234-1059",
            "fax_number": "574-234-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMARAIS",
        "first_name": "JON",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006317A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Philip Depauw, M.D.
• Miranda Depoy
• D'Angela Depriest Bey
• Derby Home Care LLC
• Renee Louise Derosa, MSW
• Paul Herman Desmarais, M.D.
• Melinda Deubner, PHARMD
• Developmental Neuropsychological Services, P.C.
• James Devereaux, MD
• Debra A. Devreese, NP

• Physical Therapist in South Bend, IN
• Providers in South Bend, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.