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KASSIDY DESROCHE
NPI 1881368645
Student in an Organized Health Care Education/Training Program in Tulsa, OK

Active since August 05, 2021PECOS EnrolledAccepts Medicare Assignment
1111 W 17TH ST, TULSA, OK 74107(918) 561-1145 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kassidy Desroche NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KASSIDY DESROCHE (NPI 1881368645) is an individual student in an organized health care education/training program in Tulsa, Oklahoma and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, is affiliated with Alliancehealth Woodward, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1881368645
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKASSIDY DESROCHE
Location Address1111 W 17TH STTulsa, OK 74107-1886
Mailing Address1111 W 17th StTulsa, OK 74107-1886
Phone(918) 561-1145
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 5, 2021
NPPES CertifiedAugust 5, 2021
✔ NPI 1881368645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPhysician AssistantTaxonomy 363A00000X
1111 W 17TH ST, Tulsa, OK 74107
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Mending Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kassidy Desroche is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840633566
PECOS Enrollment IDI20240209002452
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services31 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Alliancehealth Woodward

Acute Care Hospitals · Woodward, OK
2/5 CMS rating
OwnershipProprietary
CMS Certification Number370002
Location900 17th StreetWoodward, OK 73801 · Woodward County
Emergency services

Integris Baptist Medical Center, Inc

Acute Care Hospitals · Oklahoma City, OK
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number370028
Location3300 Northwest ExpresswayOklahoma City, OK 73112 · Oklahoma County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAHAM NATHAN JAMEISON MAT, ATC
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 237-2828
MARIYA BOBEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KARLYN TANZEY
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
KAYLEY ANTHAMATTEN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
CHASE YAGER
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (405) 613-1540
MACKENZIE LYNN HATTABAUGH
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972
ASHLEE EASTMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 805-1752
DAVID ROBERT WAXMAN
Student in an Organized Health Care Education/Training Program
1111 W 17TH ST
TULSA, OK 74107
Tulsa County (918) 582-1972

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kassidy Desroche's NPI number?

The NPI number for Kassidy Desroche is 1881368645. It was assigned to this individual provider in the NPPES registry on August 5, 2021.

Where is Kassidy Desroche located?

Kassidy Desroche practices at 1111 W 17th St, Tulsa, OK 74107. The listed phone number is (918) 561-1145.

What is Kassidy Desroche's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kassidy Desroche enrolled in Medicare?

Yes. Kassidy Desroche is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kassidy Desroche accept?

Health plans from Medica and Mending Health list Kassidy Desroche as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kassidy Desroche affiliated with any hospitals?

According to CMS data, Kassidy Desroche is affiliated with Alliancehealth Woodward and Integris Baptist Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Kassidy Desroche was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.