Active NPI
Denise Ann Desjardins, PT
- Pediatric Physical Therapist
- Worcester, MA
National Provider Identifier
1659502722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 9756
- Practice address
- 484 Main St
Worcester, MA 01608-1893 - Phone
- (508) 757-2756
- Fax
- (508) 831-9768
- NPI assigned
- Aug 6, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 9756 | MA | Primary |
Addresses
Primary practice location
484 Main St
Worcester, MA 01608-1893
Mailing address
40 Crestview Dr
Malden, MA 02148-1508
Phone (617) 947-3352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9756 | MA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1659502722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CRESTVIEW DR",
"city": "MALDEN",
"state": "MA",
"postal_code": "021481508",
"telephone_number": "617-947-3352",
"fax_number": "781-605-0006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081893",
"telephone_number": "508-757-2756",
"fax_number": "508-831-9768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESJARDINS",
"first_name": "DENISE",
"middle_name": "ANN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-06",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MA",
"license": "9756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.