Angela Desantis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301052721 Issued in MI

Practice address

1700 Biddle Ave
Wyandotte, MI 48192-7205

Phone

(734) 284-2026

Fax

(734) 284-8335

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angeladesantis@mshs.allscriptsdirect.net

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.

• Mackinac Straits Health System Inc

  • Critical Access Hospital
  • Saint Ignace, MI
  • NPI 1124283502
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1881704682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD",
            "address_2": "SUITE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201802",
            "telephone_number": "313-563-3332",
            "fax_number": "313-563-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481927205",
            "telephone_number": "734-284-2026",
            "fax_number": "734-284-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "ANGELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301052721",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301052721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297792310",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "110H211300",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Decroix, FNP-C
• Fadi H Delly, M.D.
• Leon R Demers, PA
• Roberto O. Denis, M.D.
• Puja Tejas Desai
• Kaitlin V. Deters, D.O.
• Benjamin Edward Devlin-Ruelle, FNP-BC
• Devoted Dental Group Wyandotte
• Nicole Marie Dillon, PTA
• Samantha Dimario

• Internal Medicine Physician in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.