Individual provider Active NPI

Jeffrey R Desanto, M.D.

  • Diagnostic Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1992908586
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125046527 Issued in IL
Practice address
350 W. Thomas Ave
Phoenix, AZ 85013
Phone
(602) 406-6281
NPI assigned
Jun 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036125321 IL
Diagnostic Radiology Physician 2085R0202X 125046527 IL Primary

Addresses

Primary practice location

350 W. Thomas Ave
Phoenix, AZ 85013

Mailing address

11614 N 40TH PL
Phoenix, AZ 85028-2242
Phone (309) 648-8207

Other practice location 1

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone (312) 695-5753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, ND2 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
I20110110000388 IL Practitioner - Diagnostic Radiology 8527131598 Reassigns benefits to 5 organizations
I20230530001931 ND Practitioner - Diagnostic Radiology 8527131598

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Practice addresses (Care Compare)

1443 N Cleveland Ave
Chicago, IL 60610-1107
Phone 3097404272207

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 563-4270

750 N Rush St
Apt 1201
Chicago, IL 60611-2539
Phone (309) 740-4272

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036125321ILMDDiagnostic Radiology Physician
125046527ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cira Michigan PC Diagnostic Radiology CurrentSince Feb 4, 2022 Accepting new patients
Integrated Imaging Consultants LLC Diagnostic Radiology CurrentSince Feb 11, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Rush University Medical Center CurrentSince Jan 31, 2020 Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 20, 2025 Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Jul 12, 2010 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

1725 W Harrison St
Ste 456
Chicago, IL 60612
Phone (312) 563-4238

1725 W Harrison St
Ste 437
Chicago, IL 60612
Phone (312) 563-4270

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

Interoperability endpoints

  • Direct secure messaging: jdesanto158883@direct.rush.rush-health.com

Organizations & group practices 7

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.

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": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1992908586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11614 N 40TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850282242",
            "telephone_number": "309-648-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W. THOMAS AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-6281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112978",
            "country_code": "US",
            "telephone_number": "312-695-5753",
            "fax_number": "312-695-5645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESANTO",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036125321",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125046527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.