Mark Desantis, D.O.

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

License

25MB08021500 Issued in NJ

Practice address

79 Middleville Rd
Northport, NY 11768

Phone

(631) 261-4400

NPI assigned

Aug 15, 2006

Last updated

Jun 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Diagnostic Radiology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  Medicare reassignment Care Compare group NPD
• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962

  Diagnostic Radiology

  NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Family Medicine Physician
  • Murrieta, CA
  • NPI 1700295607
  NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415
  NPD

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1053424192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "FL",
            "license": "OS10292",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NJ",
            "license": "25MB08021500",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS10292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126125400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Department of Veterans Affairs Medical Center
• Lauren Deptula, M.A.
• Deepak Sadanand Desai, M.D
• Susan Desai
• Joy McFadin Deshmukh, OD
• William E Deturk, PT
• Erin Micaela Devine
• Hillary Diamond, M.D.
• James J Diaz, R.PH.

• Body Imaging Physician in Northport, NY
• Providers in Northport, NY by specialty
• Body Imaging Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.