Individual provider Active NPI

Daniel B Desiderio, MD

  • Emergency Medicine Physician
  • Lewiston, ME
National Provider Identifier
1841788916
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD25780 Issued in ME
Practice address
93 Campus Ave
Lewiston, ME 04240-6030
Phone
(207) 777-8120
Fax
(207) 777-8984
NPI assigned
Apr 24, 2018
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21523 NH
Emergency Medicine Physician 207P00000X MD25780 ME Primary

Addresses

Primary practice location

93 Campus Ave
Lewiston, ME 04240-6030

Mailing address

PO Box 95000 LBX 7650
Philadelphia, PA 19195-0001

Other practice location 1

791 Turner St Unit 2
Auburn, ME 04210-6314
Phone (207) 330-3900

Other practice location 2

80 Highland St
Laconia, NH 03246-3235
Phone (603) 524-3211

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ddesiderio1205508@direct.bsmhealth.org St. Mary's Regional Medical Center
Direct Messaging Address ddesiderio1205508@direct.bsmhealth.org St. Mary's Regional Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20220706003286 ME Practitioner - Emergency Medicine 8628323300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25780MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Regional Medical Center CurrentSince Aug 22, 2022 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Aug 22, 2022 Accepting new patients

Locations

791 Turner St
#2
Auburn, ME 04210
Phone (207) 330-3900

91 Campus Ave
Lewiston, ME 04240
Phone (207) 777-8950

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

Interoperability endpoints

  • Direct secure messaging: ddesiderio1205508@direct.bsmhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1841788916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LBX 7650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406030",
            "telephone_number": "207-777-8120",
            "fax_number": "207-777-8984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "791 Turner St Unit 2",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "ME",
            "postal_code": "042106314",
            "country_code": "US",
            "telephone_number": "207-330-3900",
            "fax_number": "207-330-3940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Highland St",
            "address_purpose": "LOCATION",
            "city": "Laconia",
            "state": "NH",
            "postal_code": "032463235",
            "country_code": "US",
            "telephone_number": "603-524-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESIDERIO",
        "first_name": "DANIEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "21523",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD25780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddesiderio1205508@direct.bsmhealth.org",
            "affiliation": "Y",
            "affiliationName": "St. Mary's Regional Medical Center",
            "address_1": "93 Campus Ave",
            "city": "Lewiston",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042406030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddesiderio1205508@direct.bsmhealth.org",
            "affiliation": "Y",
            "affiliationName": "St. Mary's Regional Medical Center",
            "address_1": "791 Turner St Unit 2",
            "city": "Auburn",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042106314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.