DR. MARK DESANTIS (NPI# 1053424192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053424192 |
| Entity Type | Individual |
| Full Name | DR. MARK DESANTIS |
| Credential | D.O. |
| Practice Address |
79 Middleville Rd Northport NY 11768 |
| Mailing Address |
79 Middleville Rd Northport NY 11768-2200 |
| Practice Telephone | 6312614400 |
| Mailing Telephone | 6312614400 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2009-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
25MB08021500 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780682559 | Mark Desantis | Physician Assistant | 118 Nature Park Rd Ste 300, Greensburg, PA 15601-6960 | 2005-07-14 |
| Street Address |
79 MIDDLEVILLE RD |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417958471 | David Wayne Gately | Psychologist | 79 Middleville Rd, Va Medical Center, Psychology Service (116b), Northport, NY 11768-2200 | 2005-08-02 |
| 1497356174 | Cynthia Abigail Serrano-colon | Nurse Practitioner | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-11-08 |
| 1225636020 | Jessie Ryan Poznack | Pathology | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-10-14 |
| 1356958094 | Alex Myunghwan Shin | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-27 |
| 1407460470 | Kimberly Ann Smith | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-07 |
| 1790398634 | Simrit Kaur Virk | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-29 |
| 1700499670 | Christine Palathinkal | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-28 |
| 1235748252 | Valerie Marie Campos | Registered Nurse | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-27 |
| 1124636634 | Da Som Kim | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-21 |
| 1518584341 | Irene Sofia Koutsidis | Social Worker | 79 Middleville Rd, Northport, NY 11768-2296 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
| 1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
| 1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
| 1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
| 1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
| 1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
| 1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
| 1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
| 1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
| 1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
| Find all providers in zip 11768 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881783785 | Nandita Wadhwa | Radiology | 79 Middleville Road, Veterans Administration Medical Center, Northport, NY 11768 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122709 | Rayane Issa | Radiology | 109 E 102nd St Apt 2g, New York, NY 10029-5896 | 2020-10-24 |
| 1992327134 | Dongmei Jiang | Radiology | 15041 26th Ave, Flushing, NY 11354-1513 | 2020-05-11 |
| 1871137828 | Vetri Sudar Jayaprakasam | Radiology | 1233 York Ave Apt 17i, New York, NY 10065-6342 | 2019-11-03 |
| 1447801808 | Elisabeth O'dwyer | Radiology | 525 E 68th St. Radiology, Cornell/new York Presbyterian, New York, NY 10021-4870 | 2019-09-26 |
| 1184038069 | Kimberly Owens | Radiology | 1783 Route 9 Ste 104, Halfmoon, NY 12065-2465 | 2014-06-18 |
| 1972876340 | Paul D Rodrigue | Radiology | 47 New Scotland Ave Ofc, Albany, NY 12208-3412 | 2012-02-16 |
| 1912289828 | Penny Saxon | Radiology | One Gustave L. Levy Place Box 1234, Department of Radiology The Mount Sinai Medical Center, New York, NY 10029-6574 | 2011-09-16 |
| 1518248657 | Kelly M Barna | Radiology | 150 E. Sunrise Highway, Lindenhurst, NY 11757 | 2011-09-02 |
| 1124319710 | Weill Medical College of Cornell University | Radiology | 516 E 72nd St, New York, NY 10021-4804 | 2011-04-29 |
| 1326345893 | Excel Imaging PC | Radiology | 7235 51st Ave, Suite B, Woodside, NY 11377-7610 | 2011-02-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.