Individual provider Active NPI

Stanley Marcus Desire, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1396208146
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
1016039 Issued in MA
Practice address
55 Fruit St # 444
Boston, MA 02114-2696
Phone
(617) 726-3030
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 1016039 MA Primary

Addresses

Primary practice location

55 Fruit St # 444
Boston, MA 02114-2696

Mailing address

55 Fruit St # 444
Boston, MA 02114-2696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WV2 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
I20230614002265 MA Practitioner - Anesthesiology 1951631860 Reassigns benefits to 2 organizations
I20250701001061 WV Practitioner - Anesthesiology 1951631860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Columbia University College of Physicians and Surgeons, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 293-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1016039MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation Anesthesiology CurrentSince Jul 28, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 28, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 1, 2023 Accepting new patients

Locations

55 Fruit St
#444
Boston, MA 02114
Phone (617) 319-3940

55 Fruit St
Boston, MA 02114

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

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

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 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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1396208146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 444",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 444",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIRE",
        "first_name": "STANLEY",
        "middle_name": "MARCUS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "1016039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.