Individual provider Active NPI

Emma Desjardins, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Portsmouth, NH
National Provider Identifier
1356836092
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
24104 Issued in NH
Practice address
67 Corporate Dr Ste 200
Portsmouth, NH 03801-2847
Phone
(603) 431-5529
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 24104 NH Primary
Physical Medicine & Rehabilitation Physician 208100000X 24104 NH

Addresses

Primary practice location

67 Corporate Dr Ste 200
Portsmouth, NH 03801-2847

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

550 1st Ave
New York, NY 10016
Phone (212) 263-7300

Other practice location 2

725 North St
Pittsfield, MA 01201-4109
Phone (413) 447-2839

Other practice location 3

55 Fruit St
Boston, MA 02114-2621
Phone (617) 952-5299

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emma.desjardins@nyulangone.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230810002371 NH Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 8921334806 Reassigns benefits to 1 organization
I20231005001565 MA Practitioner - Physical Medicine and Rehabilitation 8921334806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

67 Corporate Dr
Suite 200
Portsmouth, NH 03801-2847
Phone (603) 431-5529

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Physical Medicine & Rehabilitation CurrentSince Sep 1, 2023 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Sep 1, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Physician Corporation Current Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2023 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

300 1st Ave
Charlestown, MA 02129
Phone (617) 952-5000

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

65 Route 125
Ste 206
Lee, NH 03861
Phone (603) 868-1732

67 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 431-5529

7 Marsh Brook Dr
Ste 200
Somersworth, NH 03878
Phone (603) 742-4222

7 Marsh Brook Dr
Somersworth, NH 03878
Phone (603) 740-2250

7 Marsh Brook Dr
Ste 205
Somersworth, NH 03878
Phone (603) 740-6510

Interoperability endpoints

  • Direct secure messaging: desjardins.emma.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1356836092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CORPORATE DR STE 200",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012847",
            "telephone_number": "603-431-5529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "212-263-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 North St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012014109",
            "country_code": "US",
            "telephone_number": "413-447-2839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-952-5299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "EMMA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NH",
            "license": "24104",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NH",
            "license": "24104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emma.desjardins@nyulangone.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "550 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.