Individual provider Active NPI

Vincent Paul Desantis, MD

  • Internal Medicine Physician
  • Bristol, CT
National Provider Identifier
1972063741
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
71105 Issued in CT
Practice address
15 Riverside Ave
Bristol, CT 06010-6312
Phone
(860) 516-7593
NPI assigned
Mar 20, 2019
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 71105 CT Primary

Addresses

Primary practice location

15 Riverside Ave
Bristol, CT 06010-6312

Mailing address

167 Main St
Southington, CT 06489-2505
Phone (860) 426-0252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220721001502 CT Practitioner - Internal Medicine 0446631477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

112 Quarry Rd
Suite 220
Trumbull, CT 06611-4877
Phone (203) 374-6162

167 Main St
Southington, CT 06489-2505
Phone (860) 426-0252

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Dec 1, 2025 Accepting new patients
Bristol Hospital Multi Specialty Group, Inc Internal Medicine CurrentSince Aug 15, 2022 Accepting new patients

Locations

15 Riverside Ave
Bristol, CT 06010
Phone (860) 516-7593

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

167 Main St
Southington, CT 06489
Phone (860) 426-0252

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

112 Quarry Rd
Ste 220
Trumbull, CT 06611
Phone (203) 374-6162

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 6

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1972063741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892505",
            "telephone_number": "860-426-0252",
            "fax_number": "860-426-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RIVERSIDE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106312",
            "telephone_number": "860-516-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "VINCENT",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "71105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.