Individual provider Active NPI

Joseph G. Desantis, M.D.

  • Plastic Surgery Physician
  • Danville, PA
National Provider Identifier
1053387209
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD035244E Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-2170
Phone
(570) 271-6363
NPI assigned
Feb 27, 2006
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD035244E PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-2170

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001449680MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdesantis59847@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080407000507 PA Practitioner - Plastic and Reconstructive Surgery 8527145119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1053387209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222170",
            "telephone_number": "570-271-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "JOSEPH",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD035244E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001449680",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdesantis59847@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178222170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.