Richard A Disanto, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085001519 Issued in IL

Practice address

5201 Willow Springs Rd
La Grange, IL 60525-6537

Phone

(708) 579-0018

Fax

(708) 579-7571

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdisanto172963@direct.rush.rush-health.com
• FHIR API: https://fhirprd.edward.org/fhirprd/api/FHIR/R4/

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Hospital

  • General Acute Care Hospital
  • Naperville, IL
  • NPI 1013969013
  Medicare reassignment NPD
• Illinois Emergency Medicine Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bolingbrook, IL
  • NPI 1003150962
  Medicare reassignment
• Edward Health Ventures

  • Clinic/Center
  • Elmhurst, IL
  • NPI 1275963027

  Physician Assistant

  NPD
• Edward Hospital

  • Home Health Agency
  • Naperville, IL
  • NPI 1912930645
  NPD
• Emergency Healthcare Physicians, LTD.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Hinsdale, IL
  • NPI 1881620243
  NPD (past)
• Rush Copley Medical Group

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1194836247
  NPD (past)
• Rush Oak Park ER Physicians Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Oak Park, IL
  • NPI 1447260880
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1235290883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-579-0018",
            "fax_number": "708-579-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256537",
            "telephone_number": "708-579-0018",
            "fax_number": "708-579-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANTO",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "1046964",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1046964",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devon Acou DC, LLC
• Kelly Ann Dewolfe, APN
• Dhaval V Shah DMD PC
• Diabetic Eye Centers of America, Incorporated
• Tahyri Diaz, MD
• Dominguez Development Group Incorporated
• David R Doyle, DPM
• Dr James Young , PC
• Brian Drelicharz, LCSW
• Kayla Droessler, MS, RDN, LDN

• Medical Physician Assistant in La Grange, IL
• Providers in La Grange, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.