Individual provider Active NPI

Stephen Thomas Delessio, MD

  • Anesthesiology Physician
  • Davenport, IA
National Provider Identifier
1114903804
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
32509 Issued in IA
Practice address
1227 East Rusholme Street
Davenport, IA 52803-2498
Phone
(563) 421-1000
Fax
(563) 421-7889
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 32509 IA Primary

Addresses

Primary practice location

1227 East Rusholme Street
Davenport, IA 52803-2498

Mailing address

PO Box 1245
Bettendorf, IA 52722-0021
Phone (563) 324-8160

Other identifiers 1

IdentifierTypeStateIssuer
0173690MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephen.delessio@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32509IAMDAnesthesiology Physician

Interoperability endpoints

  • Direct secure messaging: stephen.delessio@direct.genesishealth.com

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1114903804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527220021",
            "telephone_number": "563-324-8160",
            "fax_number": "563-324-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 EAST RUSHOLME STREET",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032498",
            "telephone_number": "563-421-1000",
            "fax_number": "563-421-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELESSIO",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "32509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173690",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.delessio@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1227 East Rusholme Street",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528032498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.