Desta Anthony Mobile NP Adult Health, PLLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC

Practice address

8241 Penstock Way
Manlius, NY 13104-9401

Phone

(315) 413-3848

Fax

(315) 692-4292

NPI assigned

Sep 9, 2020

Last updated

Nov 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Desta Rowena AnthonyNPI 1093721102

Title

Owner

Phone

(315) 559-1965

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23111/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Desta Rowena Anthony, ANP

  • Adult Health Nurse Practitioner
  • Manlius, NY
  • NPI 1093721102
  Medicare reassignment Care Compare group NPD Authorized official
• Christopher John Norman, MSN, APRN, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Syracuse, NY
  • NPI 1326442476
  Medicare reassignment Care Compare group NPD
• Ann Macwan

  • Adult Health Nurse Practitioner
  • East Syracuse, NY
  • NPI 1568138394
  Medicare reassignment

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764288000000",
    "number": "1679188494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8241 PENSTOCK WAY",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049401",
            "telephone_number": "315-559-1965",
            "fax_number": "833-606-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8241 PENSTOCK WAY",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049401",
            "telephone_number": "315-413-3848",
            "fax_number": "315-692-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "DESTA",
        "authorized_official_middle_name": "ROWENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-559-1965"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D.G. Baker Mental Health Counseling Services, PLLC
• Stacy Marie Davison, LCSW
• Susan Marie Demas, P.T.
• Department of Medicine MSG (Manlius)
• Melissa Desmond
• Neiha Dhar, MS, LMFT
• Charles Dicosimo III, DMD, MSD
• Geraldine Mary Dicosimo, M.S., R.N., C.S.
• Donald M. Dixon
• Carolyn Bradford Dragon, DMD, MSD

• Adult Health Nurse Practitioner in Manlius, NY
• Providers in Manlius, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.