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

Mr. Roger L Deshong, PA

Individual provider Surgical Physician Assistant · NPI 1164483335

Mr. Roger L Deshong, PA is a Physician Assistant in Randallstown, Maryland. Qualified in 2002, 24 years ago. Practices with Lifebridge Community Physicians Inc, a 185-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
24
Licensed in
MD
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone: (410) 521-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence C0002602 (MD)

Record details

NPI number1164483335
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 29, 2006
Last updated in NPPESOctober 19, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Lifebridge Community Physicians Inc — 185 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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