Individual provider Active NPI

Elise Desperito, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1972539153
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2103351 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032
Phone
(212) 305-9335
Fax
(212) 305-8636
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2103351 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032

Mailing address

630 West 168TH Street
Columbia Presbyterian Radiology MC 28
New York, NY 10032
Phone (212) 305-1948

Other identifiers 4

IdentifierTypeStateIssuer
W35021OtherNYMEDICARE GROUP #
1467560854OtherNYNPI GROUP#
02186203OtherNYMEDICAID GROUP #
01892819MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040323001927 NY Practitioner - Diagnostic Radiology 3870484207 Reassigns benefits to 4 organizations
I20241202000813 NJ Practitioner - Diagnostic Radiology 3870484207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians
MSK BergenGroup PAC ID 1456614114, 254 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

136 Mountain View Blvd
Basking Ridge, NJ 07920-3444

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.9 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2103351NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Apr 1, 2005 Accepting new patients
MSK Monmouth Diagnostic Radiology CurrentSince Sep 20, 2024 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Oct 1, 2017 Accepting new patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey Diagnostic Radiology CurrentSince Sep 20, 2024 Accepting new patients
MSK Bergen Diagnostic Radiology CurrentSince Sep 20, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Aug 15, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Northeast Radiology PC Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

622 W 168th St
Ph 3303
New York, NY 10032
Phone (212) 305-2654

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 304-6309

630 W 168th St
#28
New York, NY 10032
Phone (212) 305-1948

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#4100
New York, NY 10032
Phone (212) 305-5123

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 11

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 5

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1972539153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 WEST 168TH STREET",
            "address_2": "COLUMBIA PRESBYTERIAN RADIOLOGY MC 28",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-1948",
            "fax_number": "212-305-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-9335",
            "fax_number": "212-305-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPERITO",
        "first_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2103351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "W35021",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP#",
            "identifier": "1467560854",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "02186203",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01892819",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.