Manjul Dilipbhai Derasari

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

ME54111 Issued in FL

Practice address

36763 Eiland Blvd Ste 201
Zephyrhills, FL 33542

Phone

(813) 977-6688

Fax

(813) 355-5060

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Interventional Pain ManagementAlso: Anesthesiology, Pain Management

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (8 of 10)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: mderasari8405@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment Care Compare group NPD
• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Florida Medical Clinic, LLC

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Ohi West Medical Group II LLC

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• American Anesthesiology Associates of Florida, Inc.

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1134232754
  NPD (past)
• Ohi West Medical Group II LLC

  • Physiological Laboratory
  • Zephyrhills, FL
  • NPI 1679344394
  NPD (past)
• Wiregrass Ranch ASC Holdings LLC

  • Ambulatory Surgical Clinic/Center
  • Tampa, FL
  • NPI 1750456539
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1912969775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36763 EILAND BLVD STE 201",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "33542",
            "telephone_number": "813-977-6688",
            "fax_number": "813-355-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1912 E Busch Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336128666",
            "country_code": "US",
            "telephone_number": "813-933-5900",
            "fax_number": "813-935-9687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1912 E Busch Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336128666",
            "country_code": "US",
            "telephone_number": "813-933-5900",
            "fax_number": "813-935-9687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Via Bella Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346395429",
            "country_code": "US",
            "telephone_number": "813-977-6688",
            "fax_number": "813-355-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERASARI",
        "first_name": "MANJUL",
        "middle_name": "DILIPBHAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0054111",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME54111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064751900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "39715",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "11609R",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pain@flmed.directbygreenway.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2100 Via Bella Blvd Ste 103",
            "city": "Land O Lakes",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346395429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Arleen Delgado, RDH
• Tomas Edwin Delgado, M.D.
• Beverly Deliz Tirado, M.D.
• Elizabeth J. Demers, DO
• Mychal Vincent Denton, PHARMD
• Joseph Derbyshire, D.O.
• Dimple Rahul Desai, PA-C
• Salil Desai, DPM
• Vijay Desai, MD
• Alexis Desanzo

• Interventional Pain Medicine Physician in Zephyrhills, FL
• Providers in Zephyrhills, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.