Kevin J Desantis, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME58093 Issued in FL

Practice address

1912 Kings Hwy Unit 700
Port Charlotte, FL 33980-4305

Phone

(941) 255-0032

Fax

(941) 391-5213

NPI assigned

Jul 24, 2006

Last updated

Jun 3, 2024By the provider in NPPES

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 FL

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

Specialty

Emergency Medicine

Education

New York Medical College, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assisted Home Health Inc Home health agency, Punta Gorda, FL, CCN 683178

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.desantis.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• St. Joseph Emergency Medical Physicians PA

  dba Florida Regional Emergency Associates

  • Emergency Medicine Physician
  • Port Charlotte, FL
  • NPI 1053358903
  Medicare reassignment NPD Authorized official
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Palm Springs Imaging Assoc

  • Diagnostic Radiology Physician
  • Hialeah, FL
  • NPI 1740388495
  NPD (past)
• Port Charlotte Hma Physician Management LLC

  dba Neurology Associates of Charlotte County

  • Family Medicine Physician
  • Punta Gorda, FL
  • NPI 1003985573
  NPD (past)
• Port Charlotte Hma Physician Management LLC

  dba Shorepoint Obstetrics and Gynecology- RHC

  • Rural Health Clinic/Center
  • Arcadia, FL
  • NPI 1730672379
  NPD (past)
• South Miami Criticare Inc.

  • Emergency Medicine Physician
  • South Miami, FL
  • NPI 1306878210
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Assisted Home Health Inc.

  • Home Health Agency
  • Punta Gorda, FL
  • NPI 1497177604
  Care Compare affiliation

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1255353595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 KINGS HWY UNIT 700",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339804305",
            "telephone_number": "941-255-0032",
            "fax_number": "941-391-5213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Tamiami Trl Ste A",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339523922",
            "country_code": "US",
            "telephone_number": "941-624-2704",
            "fax_number": "941-627-6066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME58093",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME58093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064805100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhona Holganza Depaul, M.D.
• April Depombo, DO
• Shelley Dereu, LCSW
• Dermatology Group of Florida PA
• Brandon Edward Derouchie, DPT
• Natalie Suzanne Desantis, APRN
• Diane Marie Desilets, OTR/L
• Brittany Lukeyanna Desyr, DMD
• Pallavi Ravi Devaguptapu, O.T
• Laura M Devore, PMHNP

• General Practice Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.