Kassidy Desroche, is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Tulsa, Oklahoma. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Integris Cardiovascular Physicians Llc and her current practice location is
1111 W 17th St, Tulsa, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 561-1145.
Kassidy Desroche is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1881368645.
Provider's Profile
| Full Name | Kassidy Desroche |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 2 Years |
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| Location | 1111 W 17th St, Tulsa, Oklahoma |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kassidy Desroche graduated from nursing school in 2023
NPI Data:
- NPI Number: 1881368645
- Provider Enumeration Date: 08/05/2021
- Last Update Date: 08/05/2021
Medicare PECOS Information:
- PECOS PAC ID: 0840633566
- Enrollment ID: I20240209002452
Medical Identifiers
Medical identifiers for Kassidy Desroche such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881368645 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Integris Cardiovascular Physicians Llc | 3577730068 | 105 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kassidy Desroche is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kassidy Desroche,
1111 W 17th St,
Tulsa, OK 74107-1886
Ph: () - | Kassidy Desroche,
1111 W 17th St,
Tulsa, OK 74107-1886
Ph: (918) 561-1145 |
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