Maryanne Desantis, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

190585 Issued in NY

Practice address

375 Seguine Ave
Staten Island, NY 10309-3932

Phone

(718) 226-2440

NPI assigned

Nov 30, 2005

Last updated

Aug 1, 2008By the provider in NPPES

Sex

Female

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 4

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Atlanticare Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Hammonton, NJ
  • NPI 1093873556
  Medicare reassignment NPD
• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545
  Medicare reassignment NPD
• Stress Care of New Jersey, LLC

  • Community/Behavioral Health Agency
  • Matawan, NJ
  • NPI 1033433834
  Medicare reassignment NPD
• Atlanticare Behavioral Health, Inc

  • Community/Behavioral Health Agency
  • Hammonton, NJ
  • NPI 1982143954
  NPD
• Family Guidance Center of Warren County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Washington, NJ
  • NPI 1417937210
  NPD
• Stress Care of New Jersey, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Somerset, NJ
  • NPI 1982345567
  NPD
• Michael T. Levy, M.D., P.C.

  • Mental Health Counselor
  • New York, NY
  • NPI 1124200597
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1174507594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "6TH FL. PAYER RELATION",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-1008",
            "fax_number": "718-226-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SEGUINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093932",
            "telephone_number": "718-226-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "MARYANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "190585",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "190585",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "190585",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00602172",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP #",
            "identifier": "DN0541",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260049316",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02106196",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle N Desantis, CF-SLP, TSSLD
• Jessica Desantis
• Jo C Desantis, MD
• Joseph Louis Desantis, DDS
• Judy Desantis
• Reina Desantis
• Michael D. Desarlo, MS SPECIAL ED.
• Krisiya Ilianna Deschamps-Perez, RN
• Elleana Deschamps
• Joseph Desena, MD

• Psychiatry Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.