Individual provider Active NPI

Kingel N Desai, PA-C

  • Physician Assistant
  • Canton, GA
National Provider Identifier
1932539293
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7060 Issued in GA
Practice address
2020 Cumming Hwy Ste 102
Canton, GA 30115-8071
Phone
(678) 593-1295
Fax
(678) 593-1294
NPI assigned
Nov 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7060 GA Primary

Addresses

Primary practice location

2020 Cumming Hwy Ste 102
Canton, GA 30115-8071

Mailing address

2020 Cumming Hwy Ste 102
Canton, GA 30115-8071
Phone (678) 593-1295

Other identifiers 1

IdentifierTypeStateIssuer
003141264GMedicaidGA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20140107000836 GA Practitioner - Physician Assistant 4486882958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1340 Upper Hembree Rd
Suite a
Roswell, GA 30076-0927
Phone (770) 569-0777

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

Hospital & facility affiliations

  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7060GAMDAnesthesiologist Assistant

Interoperability endpoints

  • Direct secure messaging: kingel.desai@ud.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1932539293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "KINGEL",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141264G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.