NPIMap

Organization Active NPI

Desai Medical Center for Primary Care and Integrative Medicine PA

Doing business as Integrated Family Medical Center

  • Primary Care Clinic/Center
  • Lady Lake, FL
National Provider Identifier
1881831576
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME92848 Issued in FL
Legal business name
DESAI MEDICAL CENTER FOR PRIMARY CARE AND INTEGRATIVE MEDICINE PA
Doing business as
Integrated Family Medical Center
Practice address
773 County Road 466
The Summit of Lady Lake
Lady Lake, FL 32159-6340
Phone
(321) 274-1864
Fax
(352) 259-1132
NPI assigned
Jan 16, 2009
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Dr. Kalpana P Desai, M.D.NPI 1013020593
Title
Owner
Phone
(321) 274-1864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME92848 FL Primary

Addresses

Primary practice location

773 County Road 466
The Summit of Lady Lake
Lady Lake, FL 32159-6340

Mailing address

773 CR 466
The Summit of Lady Lake
Lady Lake, FL 32159-6340
Phone (321) 274-1864

Other identifiers 1

IdentifierTypeStateIssuer
280106000MedicaidFL

Other names 1

  • Integrated Family Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090310000367 FL Part B Supplier - Clinic/Group Practice 6507922978 Receives reassigned benefits from 6 practitioners
Practice locations: Lady Lake, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1881831576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 CR 466",
            "address_2": "THE SUMMIT OF LADY LAKE",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321596340",
            "telephone_number": "321-274-1864",
            "fax_number": "352-259-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 COUNTY ROAD 466",
            "address_2": "THE SUMMIT OF LADY LAKE",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321596340",
            "telephone_number": "321-274-1864",
            "fax_number": "352-259-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESAI MEDICAL CENTER FOR PRIMARY CARE AND INTEGRATIVE MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2020-11-06",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "KALPANA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-274-1864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME92848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280106000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integrated Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.