Individual provider Active NPI

Jo C Desantis, MD

  • Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1336234350
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
181242 Issued in NY
Practice address
75 Vanderbilt Ave
Continuing Day Treatment
Staten Island, NY 10304-2604
Phone
(718) 181-5385
NPI assigned
Oct 4, 2006
Last updated
Jun 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 181242 NY Primary

Addresses

Primary practice location

75 Vanderbilt Ave
Continuing Day Treatment
Staten Island, NY 10304-2604

Mailing address

75 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (718) 818-5385

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080519000745 NY Practitioner - Psychiatry 7113096058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York Medical College, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1130 S Ave
Staten Island, NY 10314-3410
Phone (718) 818-6132

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Feb 6, 2011 Accepting new patients
Amboy Medical Practice PC Psychiatry CurrentSince Feb 6, 2011 Accepting new patients
Richmond University Medical Center Past Accepting new patients

Locations

275 Castleton Ave
Staten Island, NY 10301
Phone (718) 447-2829

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

75 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 354-6000

Networks

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

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 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1336234350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VANDERBILT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042604",
            "telephone_number": "718-818-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VANDERBILT AVE",
            "address_2": "CONTINUING DAY TREATMENT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042604",
            "telephone_number": "718-181-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "JO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "181242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.