James Leonard Desantis, DDS & MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

048526 Issued in NY

Practice address

535 Columbia Drive
Johnson City, NY 13790

Phone

(607) 729-5900

Fax

(607) 729-6500

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Maxillofacial SurgeryAlso: Oral Surgery

Education

State University of New York at Buffalo School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394
• Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Mountainview Oral & Maxillofacial Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnson City, NY
  • NPI 1922278480

  NY, Oral and Maxillofacial Surgery

  Medicare reassignment NPD Authorized official

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

• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580

  Hospital

  Care Compare affiliation
• United Health Services Hospitals, Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1518998699

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1295898286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 COLUMBIA DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137903302",
            "telephone_number": "607-729-5900",
            "fax_number": "607-729-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 COLUMBIA DRIVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-729-5900",
            "fax_number": "607-729-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "JAMES",
        "middle_name": "LEONARD",
        "credential": "DDS & MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "048526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02395297",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Delrosario-Mantz, CRNA
• Kathleen Denicola-Prechtl
• Ishpal Deol, MBBS
• Kathleen Depersis, MA, CCC-SLP
• Perika Shaugn Deroche, MD
• Kelly Marie Devine
• Ludovica Di Gaetano, DO
• Wadih Diab, MD
• Catherine Dickinson, M.D.
• Rebekah Dickman, NP

• All providers in Johnson City, NY
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.