Stephen M Delisi, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

48123 Issued in MN

Practice address

700 Raymond Ave Ste 130
Saint Paul, MN 55114-1778

Phone

(612) 699-7778

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: stephen.delisi.1@22578.direct.athenahealth.com

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1528063765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAYMOND AVE STE 130",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141778",
            "telephone_number": "612-699-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAYMOND AVE STE 130",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141778",
            "telephone_number": "612-699-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISI",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MN",
            "license": "48123",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "46660",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "48123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34550800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vera Yvonne Delay, MA OTR/L
• Roberta Lynn Delfun, PT
• Ashley Delgado
• Krysta Nicole Delgado
• Delight Home Care, Inc
• Chanah M Delisle, MD
• Delle Jacobs, Limited
• Stephen Anthony Delong, LICSW
• Amanda N Delsman, PSYD LP
• Delta Academy of Technology and Innovation

• Psychiatry Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.