Individual provider Active NPI

Anthony John Desmarais II, D.O.

  • Family Medicine Physician
  • The Villages, FL
National Provider Identifier
1073048138
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS16681 Issued in FL
Practice address
2771 Brownwood Blvd
The Villages, FL 32163-2005
Phone
(352) 750-8220
NPI assigned
Apr 26, 2017
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT017644 PA
Family Medicine Physician 207Q00000X OS019901 PA
Family Medicine Physician 207Q00000X OS16681 FL Primary

Addresses

Primary practice location

2771 Brownwood Blvd
The Villages, FL 32163-2005

Mailing address

1503 Buenos Aires Blvd Ste 110
Lady Lake, FL 32159-6825
Phone (352) 750-8220

Other practice location 1

1503 Buenos Aires Blvd Ste 110
Lady Lake, FL 32159-6825
Phone (352) 750-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200629000327 FL Practitioner - Family Practice 7012250947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Rivers Family Medicine PAGroup PAC ID 8224042106, 6 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
The Villages, FL 32162-1762
Phone (352) 693-3378

1503 Buenos Aires Blvd
Suite 110
The Villages, FL 32159-6825
Phone (352) 205-4302

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

5036 SE 110TH St
Belleview, FL 34420-3759
Phone (352) 693-3378

8768 SE 165TH Mulberry LN
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS019901PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rivers Family Medicine PA Family Medicine CurrentSince May 28, 2020 Accepting new patients

Locations

1503 Buenos Aires Blvd
Ste 110
The Villages, FL 32159
Phone (352) 205-4302

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IADBAA/Endpoint/IADBAA

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1073048138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BUENOS AIRES BLVD STE 110",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321596825",
            "telephone_number": "352-750-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632005",
            "telephone_number": "352-750-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1503 Buenos Aires Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321596825",
            "country_code": "US",
            "telephone_number": "352-750-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESMARAIS",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT017644",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS019901",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.