NPIMap

Individual provider Active NPI

Lara Anne Desanti-Siska, M.D.

  • Family Medicine Physician
  • Wainscott, NY
National Provider Identifier
1255349692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
241095-1 Issued in NY
Practice address
386 Montauk Hwy
Suite 5
Wainscott, NY 11975
Phone
(631) 537-3765
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 241095-1 NY Primary

Addresses

Primary practice location

386 Montauk Hwy
Suite 5
Wainscott, NY 11975

Mailing address

61 N Main St
East Hampton, NY 11937-2601
Phone (631) 324-9429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000497 NY Practitioner - Family Practice 5395744007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

240 Meeting House LN
Southampton, NY 11968-5009
Phone (631) 726-8400

325 Meeting House LN
Southampton, NY 11968-7000

3330 Noyac Rd
Sag Harbor, NY 11963-1930
Phone (631) 725-2112

34 E Montauk Hwy
Suite 4
Hampton Bays, NY 11946-1866
Phone (631) 728-0505

386 Montauk Hwy
Suite 5
Wainscott, NY 11975-2000
Phone (631) 537-3765

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241095-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC CurrentSince Jul 1, 2009 Accepting new patients
South Fork Medical Associates PC Past Accepting new patients
Merritt B White DO PC Family Medicine Past Accepting new patients

Locations

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

Networks

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

Interoperability endpoints

  • Direct secure messaging: lara.desantisiska.p1@direct.shproviders.nextgenshare.com

Organizations & group practices 3

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 8

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255349692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 N MAIN ST",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119372601",
            "telephone_number": "631-324-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 MONTAUK HWY",
            "address_2": "SUITE 5",
            "city": "WAINSCOTT",
            "state": "NY",
            "postal_code": "11975",
            "telephone_number": "631-537-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTI-SISKA",
        "first_name": "LARA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "241095-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wainscott, NY

Sources for this page

Verify at the official NPI Registry.