Active NPI
Elise Desperito, MD
- Diagnostic Radiology Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2103351
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W35021 | Other | NY | MEDICARE GROUP # |
| 1467560854 | Other | NY | NPI GROUP# |
| 02186203 | Other | NY | MEDICAID GROUP # |
| 01892819 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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 100
- Quality
- 81.6
- Improvement activities
- 40
- Cost
- 10
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2103351 | NY | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Diagnostic Radiology | Current | Accepting new patients |
| MSK Monmouth | Diagnostic Radiology | Current | Accepting new patients |
| Columbiadoctors/Newyork-Presbyterianimaging | Current | Accepting new patients | |
| Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey | Diagnostic Radiology | Current | Accepting new patients |
| MSK Bergen | Diagnostic Radiology | Current | 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 | Current | Accepting new patients |
| Mskcc Radiology Group | Diagnostic Radiology | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Current | 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
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- 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.
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1639159692
-
- Medical Oncology Physician
- Basking Ridge, NJ
- NPI 1184637886
Diagnostic Radiology
-
- Specialist
- New York, NY
- NPI 1902345986
-
dba Columbia Presbyterian Radiologists
- Diagnostic Radiology Physician
- New York, NY
- NPI 1467560854
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Diagnostic Radiology
-
- Internal Medicine Physician
- New York, NY
- NPI 1861907321
-
- Diagnostic Radiology Physician
- Mount Kisco, NY
- NPI 1255320727
-
dba Kreitcman Pet Center
- Nuclear Radiology Physician
- New York, NY
- NPI 1730297011
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- Special Hospital
- New York, NY
- NPI 1770046351
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.