Michelle Anna Detka

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PA-1450 Issued in AR

Practice address

2601 Gene George Blvd
Springdale, AR 72762-0845

Phone

(479) 725-6800

Fax

(479) 725-6582

NPI assigned

Dec 2, 2020

Sex

Female

Sole proprietor

Yes

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 FL, HI, AR3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kapiolani Medical SpecialistsGroup PAC ID 0648183988, 103 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.58 of 100Reported as group

Quality

74.46

Promoting interoperability

97

Improvement activities

40

Cost

73.31

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Kapiolani Medical Specialists

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1124071014

  HI

  Medicare reassignment Care Compare group
• Arkansas Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464

  AR

  Medicare reassignment NPD
• Tenet Florida Physician Services II, LLC

  • Orthopaedic Surgery Physician
  • West Palm Beach, FL
  • NPI 1912266420

  FL

  Medicare reassignment
• Tenet Florida Physician Services II, LLC

  • Durable Medical Equipment & Medical Supplies
  • Boca Raton, FL
  • NPI 1770391286
  NPD
• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  NPD
• Arkansas Childrens Hospital

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1770889552
  NPD (past)

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1669077152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6800",
            "fax_number": "479-725-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-725-6800",
            "fax_number": "479-725-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETKA",
        "first_name": "MICHELLE",
        "middle_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": "PA-1450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle N Derose, LPC, LMFT
• Pooja Desai, PHARMD
• Marsha Dell Desillas, OTR/L
• Shirin Ramani Desilva, MD
• Sloane Lawson Deterding, OTR-L
• Alexander Dallas Dettmers, DPT
• Coty Deutschman, LPN
• Stephen Dewbre
• Krista Deweese, OTD, OTR/L
• Ryley Elizabeth Dewey

• All providers in Springdale, AR
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.