Keith F Desonier Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06946 Issued in TX

Practice address

1001 12TH Ave Ste 140
Fort Worth, TX 76104-3926

Phone

(817) 871-9069

Fax

(817) 871-9067

NPI assigned

Oct 7, 2010

Last updated

Jun 9, 2011By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Center for Urology LLPGroup PAC ID 6002076882, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: keithdesonier@lonestaruro.medalliesdirect.net

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.

• Texas Center for Urology LLP

  • Urology Physician
  • Fort Worth, TX
  • NPI 1366710196
  Medicare reassignment Care Compare group
• Dr Robert Stroud, P.a.

  • Urology Physician
  • Fort Worth, TX
  • NPI 1649542168
  NPD
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Texas Health Huguley, Inc

  dba Texas Health Huguley Hospital Fort Worth South

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1518355759
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Texas Health Huguley Hospital Fort Worth South

  • General Acute Care Hospital
  • Burleson, TX
  • NPI 1033120423
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Huguley Memorial Medical Center

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1548273881
  Care Compare affiliation

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1760792857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-871-9069",
            "fax_number": "817-871-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-871-9069",
            "fax_number": "817-871-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESONIER",
        "first_name": "KEITH",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218752802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218752803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218752801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caris Anne Deschner, CRNA
• Ty Desilets, PT
• Brenda Desire
• Madison Deskins, APRN-CNP
• Tammy Desko, M.A., LPC
• Fenelle Camille Desrosin-Alexandre, RN
• Destination Chiropractic LLC
• Destiny Medical Supplies Inc.,
• Detoelarization LLC
• Alliana Leigh Labis Detorio, DO

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.