Organization Active NPI

Stephen M. Desio, M.D., P.C.

  • Specialist
  • Worcester, MA
National Provider Identifier
1760406441
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
80965 Issued in MA
Legal business name
STEPHEN M. DESIO, M.D., P.C.
Practice address
123 Summer St
Suite 520
Worcester, MA 01608-1216
Phone
(508) 363-6363
Fax
(508) 363-6366
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Authorized official

Name
Dr. Stephen M. Desio, M.D.
Title
President
Phone
(508) 363-6363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 80965 MA Primary

Addresses

Primary practice location

123 Summer St
Suite 520
Worcester, MA 01608-1216

Mailing address

23A Castle Rd
Northborough, MA 01532-1248

Other identifiers 2

IdentifierTypeStateIssuer
M21433OtherMAPTAN
9729411MedicaidMA

National Provider Directory

National Provider Directory

Locations

123 Summer St
Ste 520
Worcester, MA 01608
Phone (508) 363-6361

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1760406441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23A CASTLE RD",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015321248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "address_2": "SUITE 520",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6363",
            "fax_number": "508-363-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M. DESIO, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "DESIO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-363-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "80965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "M21433",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9729411",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.