Individual provider Active NPI

Douglas Harold Desantis, MD

  • Internal Medicine Physician
  • Havelock, NC
National Provider Identifier
1275509705
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2013-00353 Issued in NC
Practice address
532 Webb Blvd
Havelock, NC 28532-2042
Phone
(252) 447-7088
Fax
(252) 447-2752
NPI assigned
Feb 24, 2006
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2013-00353 NC Primary

Addresses

Primary practice location

532 Webb Blvd
Havelock, NC 28532-2042

Mailing address

PO Box 896206
Charlotte, NC 28289-6206
Phone (252) 447-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130816000589 NC Practitioner - Internal MedicinePractitioner - Anesthesiology 0547318875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinaeast PhysiciansGroup PAC ID 0143378117, 203 clinicians

Practice addresses (Care Compare)

137 Medical LN
Pollocksville, NC 28573-8200
Phone (252) 633-1010

2604 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4238
Phone (252) 636-1919

2636 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4238
Phone (252) 636-1919

4218 Arendell St
Morehead City, NC 28557-2866
Phone (252) 247-3257

532 Webb Blvd
Havelock, NC 28532-2042
Phone (252) 633-2712

906 WB McLean Blvd
Cape Carteret, NC 28584-9211
Phone (252) 393-9007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.61 of 100Reported as group
Quality
57.39
Promoting interoperability
68
Improvement activities
40
Cost
77.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00353NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients
Carolinaeast Physicians Internal Medicine Current Accepting new patients
Carolinaeast Physicians CurrentSince Jul 1, 2013 Accepting new patients
Appledore Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

Interoperability endpoints

  • Direct secure messaging: ddesantis19364@carolinaeastmc.direct-ci.com

Organizations & group practices 4

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 3

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1275509705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896206",
            "telephone_number": "252-447-7088",
            "fax_number": "252-447-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 WEBB BLVD",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285322042",
            "telephone_number": "252-447-7088",
            "fax_number": "252-447-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "DOUGLAS",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-00353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havelock, NC

Sources for this page

Verify at the official NPI Registry.