MR. GAUTAM D DESAI


Address: 2020 S Independence Blvd, Suite #3, Virginia Beach, VA 23453
Phone: 7574716977

MR. GAUTAM D DESAI (NPI# 1417047663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417047663
Entity Type Individual
Full Name MR. GAUTAM D DESAI
Credential MD
Practice Address 2020 S Independence Blvd
Suite #3
Virginia Beach
VA 23453
Practice Telephone 7574716977
Practice Fax Number 7574715300
Mailing Telephone 7574716977
Mailing Fax Number 7574715300
Enumeration Date 2006-10-16
Last Update Date 2010-06-24
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 0101045379 VA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
BLUE CROSS/BLUE SHIELD 332419 01
VA 005628881 05
RR MEDICARE 080100260 01

Other Providers GAUTAM DESAI

NPI Name Taxonomy Address Enumeration
1245242510 Gautam J Desai Internal Medicine 842 Broadway, West Long Branch, NJ 07764-1503 2006-08-13
1639116742 Gautam T Desai Internal Medicine 447 Rt 10, Suite 2, Randolph, NJ 07869 2006-05-31
1881633071 Gautam Desai Family Medicine 1010 Carondelet Dr, Suite #220, Kansas City, MO 64114-4859 2006-06-05

Office Location

Street Address 2020 S INDEPENDENCE BLVD
SUITE #3
City VIRGINIA BEACH
State VA
Zip Code 23453

Providers in the same location

NPI Name Taxonomy Address Enumeration
1487609004 Arturo Busante Gonzalez II Chiropractor 2020 S Independence Blvd, Suite 6, Virginia Beach, VA 23453-4776 2006-05-23
1134512486 Kathleen Danielle Brown Nurse Practitioner 2020 S Independence Blvd, #5, Virginia Beach, VA 23453-4776 2015-03-11
1235486473 Judy Goldson Jackson Nurse Practitioner 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 2012-08-07
1750636270 Jenifer Cotter Nurse Practitioner 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 2012-07-20
1639260680 Jitendra Patel Family Medicine 2020 S Independence Blvd, Ste 1, Virginia Beach, VA 23453 2006-09-27
1316038383 Myrna Espinosa Family Medicine 2020 S Independence Blvd, Virginia Beach, VA 23453-4776 2006-09-27
1104917145 Family & Internal Medical Cntr Family Medicine 2020 S Independence Blvd, Virginia Beach, VA 23453-4776 2006-09-27
1861583841 Kanak Roy Family Medicine 2020 S Independence Blvd, Virginia Beach, VA 23453-4776 2006-09-27
1881619518 Dawn Angelique Wilson Chiropractor 2020 S Independence Blvd, Suite 6, Virginia Beach, VA 23453-4776 2006-07-13
1033147798 Alliance Chiropractic & Rehabilitation Chiropractor 2020 S Independence Blvd, Suite 6, Virginia Beach, VA 23453-4776 2006-06-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407346109 Sumaca S.a De C.v. General Acute Care Hospital Paseo De La Marina Int 4116, El Medano, San Jose Del Cabo, BAJA CALIFORNIA SUR 23453 2018-05-17
1336644814 Jessica Zuckerman Family Medicine 2309 Nettleford Way, Virginia Beach, VA 23453 2018-03-27
1811359623 Jana Leigh Dillon Behavioral Analyst 3101 Magic Hollow Blvd Ste 101, Virginia Beach, VA 23453 2016-03-22
1679903249 Carmen Robinson Physical Therapy Assistant 3729 Purebred Dr, Virginia Beach, VA 23453 2013-11-19
1386986891 Christina Pryor Behavioral Analyst Nbc 1531 Amberley Forest Road, Virginia Beach, VA 23453 2013-03-22
1417222415 Rebecca Lynn Dahlka Contractor 1404 Planting Ct., Virginia Beach, VA 23453 2012-03-09
1730405879 Coastal Dermatology P.C. Dermatology 3176 Holland Rd., 103, Virginia Beach, VA 23453 2010-04-14
1235466277 Michael Allen Brasko Specialist/Technologist, Other 2604 Olympic Drive, Virginia Beach, VA 23453 2009-11-12
1518101385 Matthew Faauli Social Worker 3134 Magic Hollow Blvd, Ste 200, Virginia Beach, VA 23453 2009-04-23
1104902246 Cynthia Tapp Elswick Social Worker 3432 Magic Hollow Blvd, Suite 200, Va. Beach, VA 23453 2006-10-31
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326652900 Liliana Kim Family Medicine 2908 Pepperlin Dr, Virginia Beach, VA 23456-3524 2020-09-01
1699236026 Helen Everett Frankos Family Medicine 748 Sequoia Way, Virginia Beach, VA 23451-4472 2019-03-28
1336644814 Jessica Zuckerman Family Medicine 2309 Nettleford Way, Virginia Beach, VA 23453 2018-03-27
1538699038 Promethean Group Family Medicine 3920 Vanderhorst Dr, Virginia Beach, VA 23462-7531 2017-06-16
1407385172 Ashley Watson Family Medicine 513 Boswell Ct, Virginia Beach, VA 23452-5857 2017-06-07
1376930073 Ashley A Burkholder Family Medicine 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 2015-04-20
1053754358 Jonathan Gellman Family Medicine 1200 Lake James Dr, Suite 200, Virginia Beach, VA 23464-6773 2013-04-17
1003155045 Accurate Medical PC Family Medicine 3312 Doncaster Rd, Virginia Beach, VA 23452-5920 2013-02-12
1740529072 Dalene Cheek Evans Family Medicine 1201 Lake James Dr Ste 200, Virginia Beach, VA 23464-6780 2013-02-06
1326334095 Kari Ann Neamand Cheney Family Medicine 1035 Nider Blvd, St 100, Nmcp Branch Health Clinic Boone, Virginia Beach, VA 23459-2731 2011-06-21
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Competitor

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City VIRGINIA BEACH
Zip Code 23453

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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