MIRA DESAI (AGPCNP) – Gerontology Nurse Practitioner, NPI 1538559190
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,637 NURSE PRACTITIONER in IL
Provider Addresses for MIRA DESAI (AGPCNP)
PO BOX 746715
ATLANTA, GA 303746715
Phone: (773) 352-1515
Fax: (312) 929-0373
Type: Mailing
213 N RACINE AVE
CHICAGO, IL 606071644
Phone: (312) 733-9730
Type: Mailing
3046 127TH ST
BLUE ISLAND, IL 604061827
Phone: (708) 377-7920
Fax: (708) 930-0414
Type: Location
2000 N Main St Ste A
Waterbury, CT 067042364
Phone: (203) 951-8306
Type: Location
3621 Aramingo Ave Ste 5C
Philadelphia, PA 191344607
Phone: (215) 444-7472
Type: Location
3046 127th St
Blue Island, IL 604061827
Phone: (708) 377-7920
Fax: (708) 930-0414
Type: Location
2240 E 53rd St # B-1
Indianapolis, IN 462203479
Phone: (317) 933-7047
Type: Location
300 Quaker Ln # C2-4
Warwick, RI 028860159
Phone: (401) 233-5051
Type: Location
11260 E Jefferson Ave
Detroit, MI 482143320
Phone: (313) 749-0148
Fax: (313) 263-3298
Type: Location
5246 Chamberlayne Rd
Richmond, VA 232272950
Phone: (804) 913-7029
Type: Location
PO BOX 740015
ATLANTA, GA 303740015
Phone:
Type: Mailing
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA 300873306
Phone: (470) 444-3134
Fax: (470) 276-4370
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 15 Medicare enrollment records; no due dates published yet.
Enrollment records
15
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150925000574 | I | Nurse Practitioner | IL | TBD |
| I20201202002478 | I | Nurse Practitioner | MI | TBD |
| I20210127003198 | I | Nurse Practitioner | TN | TBD |
| I20220613000129 | I | Nurse Practitioner | RI | TBD |
| I20220623001853 | I | Nurse Practitioner | OH | TBD |
| I20220729002712 | I | Nurse Practitioner | GA | TBD |
| I20220805002982 | I | Nurse Practitioner | NY | TBD |
| I20220907000246 | I | Nurse Practitioner | SC | TBD |
| I20220930001784 | I | Nurse Practitioner | KY | TBD |
| I20221017001493 | I | Nurse Practitioner | NC | TBD |
| I20230328002898 | I | Nurse Practitioner | PA | TBD |
| I20230530001651 | I | Nurse Practitioner | IN | TBD |
| I20241120002384 | I | Nurse Practitioner | VA | TBD |
| I20241122002353 | I | Nurse Practitioner | CT | TBD |
| I20241208000086 | I | Nurse Practitioner | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 35 | 35 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 30374)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | IL | 83036 | Hemoglobin A1C level | 40 | 33 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MS | |
| Internal Medicine | TX | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | VA | |
| Internal Medicine | VA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | MD | |
| Nurse Practitioner | GA | |
| Family Practice | VA |
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