Active NPI
Donald Desantis, M.D.
- Surgery Physician
- Berwyn, PA
National Provider Identifier
1528034071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 200200107
- Practice address
- 552A Lancaster Ave
Berwyn, PA 19312-1635 - Phone
- (610) 644-7100
- Fax
- (610) 644-7111
- NPI assigned
- Feb 24, 2006
- Last updated
- Apr 10, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 200200107 | NC | Primary |
Addresses
Primary practice location
552A Lancaster Ave
Berwyn, PA 19312-1635
Mailing address
552A Lancaster Ave
Berwyn, PA 19312-1635
Phone (610) 644-7100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200200107 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jersey Shore Hospital Foundation, Inc | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Jersey Shore Medical Associates
- Family Medicine Physician
- Avis, PA
- NPI 1417019498
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1528034071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "552A LANCASTER AVE",
"city": "BERWYN",
"state": "PA",
"postal_code": "193121635",
"telephone_number": "610-644-7100",
"fax_number": "610-644-7111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "552A LANCASTER AVE",
"city": "BERWYN",
"state": "PA",
"postal_code": "193121635",
"telephone_number": "610-644-7100",
"fax_number": "610-644-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANTIS",
"first_name": "DONALD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "200200107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.