Individual provider Active NPI

Anselmo Deasis, M.D.

  • Internal Medicine Physician
  • Bath, NY
National Provider Identifier
1427082908
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
184984 Issued in NY
Practice address
7433 State Route 54
Bath, NY 14981
Phone
(607) 776-9198
Fax
(607) 776-9199
NPI assigned
Jul 10, 2006
Last updated
Oct 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 184984 NY Primary

Addresses

Primary practice location

7433 State Route 54
Bath, NY 14981

Mailing address

111 E 14TH St
Elmira Heights, NY 14903-1303
Phone (607) 734-9539

Other identifiers 1

IdentifierTypeStateIssuer
01267674MedicaidNY

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
I20081020000291 NY Practitioner - Internal Medicine 5193742914 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184984NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince May 1, 2016 Accepting new patients
Rochester General Hospital Internal Medicine CurrentSince May 1, 2016 Accepting new patients
Advantagehealth Medical Services, PC Past Accepting new patients
Anselmo D. Deasis M.D. Internal Medicine Past Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Rochester, NY 14621
Phone (585) 275-7741

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1427082908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 14TH ST",
            "city": "ELMIRA HEIGHTS",
            "state": "NY",
            "postal_code": "149031303",
            "telephone_number": "607-734-9539",
            "fax_number": "607-734-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7433 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "14981",
            "telephone_number": "607-776-9198",
            "fax_number": "607-776-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEASIS",
        "first_name": "ANSELMO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "184984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01267674",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.