Mark Alfred Desjardins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9300 Issued in NH

Practice address

Naval Ambulatory Care Center
Route 12 BLDG 449 Attn Professional Affairs
Groton, CT 06349-5600

Phone

(860) 694-2377

Fax

(860) 694-2590

NPI assigned

Jan 20, 2006

Last updated

May 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• CH DHC Inc

  dba Dartmouth Hitchcock Concord

  • Family Medicine Physician
  • Concord, NH
  • NPI 1083654941
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1598745911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "UNIT 33109 BOX 4713R",
            "city": "APO",
            "state": "AE",
            "postal_code": "091800947",
            "telephone_number": "860-536-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL AMBULATORY CARE CENTER",
            "address_2": "ROUTE 12 BLDG 449 ATTN PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "MARK",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "9300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Luis Delgado III
• Ellen Catherine Denigris, MD
• Dependable Home Care of CT LLC
• Shrikant R Deshpande, MD, MPH
• Pamela Johnson Desimone, M.S. CCC-SLP
• Lauren Anne Dessereaux, OTR/L
• Christopher David Deveau, DC
• Sterling Eugene Deveraux, MSW
• Shaun Singh Dhillon, OD
• Diagnostic Imaging Services of CT, LLC

• Family Medicine Physician in Groton, CT
• Providers in Groton, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.