Individual provider Active NPI

Dante V. De Jesus, MD

  • Emergency Medicine Physician
  • Montgomery, AL
National Provider Identifier
1700837317
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
26777 Issued in AL
Practice address
440 Taylor Rd
Suite 3380
Montgomery, AL 36117-3588
Phone
(334) 213-6281
Fax
(334) 213-6288
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26777 AL
Emergency Medicine Physician 207P00000X 26777 AL Primary

Addresses

Primary practice location

440 Taylor Rd
Suite 3380
Montgomery, AL 36117-3588

Mailing address

440 Taylor Rd
Suite 3380
Montgomery, AL 36117-3588
Phone (334) 213-6281

Other identifiers 2

IdentifierTypeStateIssuer
051556282MedicaidAL
1326182486OtherALHOSPITAL PHYSICIAN SERVICES OF CENTRAL ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141016001397 GA Practitioner - Emergency Medicine 9830126515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.23
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26777ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Emergency Group LLC Emergency Medicine CurrentSince Oct 27, 2024 Accepting new patients
Montgomery Baptist Outreach Services Corporation Family Medicine Past Accepting new patients
Montgomery Baptist Outreach Services Corporation Family Medicine Past Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients

Locations

865 S 1st St
Jesup, GA 31545
Phone (912) 427-6811

Interoperability endpoints

  • Direct secure messaging: dante.dejesus@direct.baptistfirst.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1700837317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 TAYLOR RD",
            "address_2": "SUITE 3380",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173588",
            "telephone_number": "334-213-6281",
            "fax_number": "334-213-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 TAYLOR RD",
            "address_2": "SUITE 3380",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173588",
            "telephone_number": "334-213-6281",
            "fax_number": "334-213-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "DANTE",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "26777",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "26777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556282",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL PHYSICIAN SERVICES OF CENTRAL ALABAMA",
            "identifier": "1326182486",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.