Deval I Desai OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DEVAL I DESAI OD PLLC

Practice address

261 Cooper Creek Dr
Mocksville, NC 27028-5967

Phone

(336) 751-2890

Fax

(336) 751-2442

NPI assigned

Feb 15, 2016

Last updated

Feb 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deval Indra Desai, O.D.NPI 1336344282

Title

Optometrist

Phone

(336) 587-6584

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deval I Desai, OD

  • Optometrist
  • Winston Salem, NC
  • NPI 1336344282
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1740649128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 BERRYHILL LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271069831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 COOPER CREEK DR",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270285967",
            "telephone_number": "336-751-2890",
            "fax_number": "336-751-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVAL I DESAI OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "DEVAL",
        "authorized_official_middle_name": "INDRA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "336-587-6584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.