Individual provider Active NPI

Lianne Deserres, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Hawthorne, NY
National Provider Identifier
1144336645
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
212745 Issued in NY
Practice address
19 Bradhurst Ave Ste 3600S
Hawthorne, NY 10532-2140
Phone
(914) 693-7636
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 212745 NY
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 212745 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave Ste 3600S
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other practice location 1

1055 Saw Mill River Rd
suite 101
Ardsley, NY 10502-1045
Phone (914) 693-7636 ext. 129

Other identifiers 1

IdentifierTypeStateIssuer
1932723MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071029000246 NY Practitioner - Otolaryngology 7416044169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aizer Health , Inc. Pediatric Otolaryngology CurrentSince Nov 1, 2022 Accepting new patients
Aizer Health , Inc. CurrentSince Nov 1, 2022 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Current Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Mar 1, 2020 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

1055 Saw Mill River Rd
Ste 101
Ardsley, NY 10502
Phone 9146937636 ext. 129

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

19 Bradhurst Ave
Ste 3600S
Hawthorne, NY 10532
Phone (914) 909-4578

49 Forest Rd
Monroe, NY 10950
Phone (845) 782-3242

48 Bakertown Rd
Monroe, NY 10950
Phone (845) 774-1464

11 Medical Park Dr
Ste 205
Pomona, NY 10970
Phone (845) 362-1350

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: deserresl@hiemail.healtheconnections.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1144336645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3600S",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-693-7636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Saw Mill River Rd",
            "address_2": "suite 101",
            "address_purpose": "LOCATION",
            "city": "Ardsley",
            "state": "NY",
            "postal_code": "105021045",
            "country_code": "US",
            "telephone_number": "914-693-7636 x129",
            "fax_number": "914-886-0027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESERRES",
        "first_name": "LIANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "212745",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NY",
            "license": "212745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932723",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.