Heather Desroches, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6363 Issued in CT

Practice address

954 Main St
Branford, CT 06405-7727

Phone

(203) 481-0003

Fax

(855) 496-0993

NPI assigned

Jul 11, 2020

Sex

Female

Sole proprietor

No

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 CT

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ear, Nose and Throat Medical and Surgical Group, LLCGroup PAC ID 5698831212, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEBFCA

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.

• Ear Nose & Throat Medical and Surgical Group, LLC

  • Otolaryngology Physician
  • North Haven, CT
  • NPI 1790854651
  Medicare reassignment Care Compare group
• Ear Nose & Throat Medical and Surgical Group, LLC

  • Nurse Practitioner
  • New Haven, CT
  • NPI 1679835086
  NPD (past)

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

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1594425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1902424393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732363",
            "telephone_number": "860-302-9414",
            "fax_number": "203-239-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064057727",
            "telephone_number": "203-481-0003",
            "fax_number": "855-496-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Prince St Ste 601",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191634",
            "country_code": "US",
            "telephone_number": "203-752-1726",
            "fax_number": "855-496-0993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Broadway",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064732363",
            "country_code": "US",
            "telephone_number": "203-234-1324",
            "fax_number": "855-496-0993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESROCHES",
        "first_name": "HEATHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-11",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter A. Deluca, M.D.
• Anita Marie Delucia, PT
• Amy Demers, DPT
• Michelle Demers, MSW
• Natalie Poonam Dequillfeldt, MD, MA
• Susan Devlin, OTR
• Brett David Devries, PA-C
• Diabetic Footwear Centers LLC
• Vincent J Difonzo, MPT
• Digestive Disease Associates Endoscopy Suite, LLC

• Physician Assistant in Branford, CT
• Providers in Branford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.