Gautam Desai, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO 119578 Issued in MO

Practice address

1010 Carondelet Dr
Suite #220
Kansas City, MO 64114-4859

Phone

(816) 941-1600

Fax

(816) 941-1699

NPI assigned

Jun 5, 2006

Last updated

Aug 29, 2016By 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 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Goppert - Trinity Family Care, LLCGroup PAC ID 8426956681, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Goppert - Trinity Family Care, LLC

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1922097013
  Medicare reassignment Care Compare group NPD
• Midwest Psychiatric Consultants, P.C.

  • Specialist
  • Lee's Summit, MO
  • NPI 1265472088
  NPD (past)
• HCA Physician Services

  • General Acute Care Hospital
  • Aventura, FL
  • NPI 1649431388
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1881633071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 HOLMES RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311150",
            "telephone_number": "816-276-7600",
            "fax_number": "816-276-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 CARONDELET DR",
            "address_2": "SUITE #220",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641144859",
            "telephone_number": "816-941-1600",
            "fax_number": "816-941-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "GAUTAM",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "DO 119578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245068309",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce James Derr, DDS
• Derrick Thomas Academy
• Matilda Dervisevic, MD
• Al Des Marteau
• Aarsh Desai
• Komal B Desai, M.D.
• Lavina Vijay Desai, M.D.
• Samvid Desai
• Eugene L Descoteaux, PT
• Alyssa Desilets, OTR/L

• Family Medicine Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.