Active NPI
Joseph William Desiato, M.D.
- Pediatrics Physician
- Andover, MA
National Provider Identifier
1356435366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 55584
- Practice address
- 349 N Main St
Andover, MA 01810-2687 - Phone
- (978) 475-0300
- Fax
- (978) 475-3279
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 55584 | MA | Primary |
Addresses
Primary practice location
349 N Main St
Andover, MA 01810-2687
Mailing address
349 N Main St
Andover, MA 01810-2687
Phone (978) 475-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3010929 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356435366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 N MAIN ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018102687",
"telephone_number": "978-475-0300",
"fax_number": "978-475-3279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 N MAIN ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018102687",
"telephone_number": "978-475-0300",
"fax_number": "978-475-3279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESIATO",
"first_name": "JOSEPH",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "55584",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3010929",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.