Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kassidy Desroche

Individual provider Physician Assistant · NPI 1881368645

Kassidy Desroche is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2023, 3 years ago. Practices with Integris Cardiovascular Physicians LLC, a 115-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1111 W 17th St
Tulsa, OK 74107-1886
Phone: (918) 561-1145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1881368645
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 5, 2021
Last updated in NPPESAugust 5, 2021
Certification dateAugust 5, 2021
Mailing address1111 W 17th St, Tulsa, OK 74107-1886

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Integris Cardiovascular Physicians Llc — 115 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tulsa