Luke V Desjarlais, PAC
Physician Assistant in Menomonee Falls, WI. Individual provider (NPI-1).
NPI number1396017992
StatusActive
Last updated in NPPESNov 25, 2024
Details
- NPI
- 1396017992
- Entity type
- Individual (NPI-1)
- Name
- Luke V Desjarlais
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2012
- Certification date
- Nov 25, 2024
- Last updated
- Nov 25, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 3268-23 | WI | Yes |
Practice location
N84w16889 Menomonee AveMenomonee Falls, WI 53051-2810
Phone 262-251-7500
Mailing address
Po Box 735044Chicago, IL 60673-5044
Phone 800-326-2250
Other practice locations
620 Shadow Ln
Las Vegas, NV 89106-4119
Las Vegas, NV 89106-4119
Phone 702-388-4506 · Fax 702-388-4810
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 42 Physician Assistant providers in Menomonee Falls · All 1,209 providers in Menomonee Falls
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