GREGORY L DESANTO (NPI# 1639163819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639163819 |
| Entity Type | Individual |
| Full Name | GREGORY L DESANTO |
| Credential | MD |
| Practice Address |
11209 N Tatum Blvd #255 Phoenix AZ 85028-3091 |
| Practice Telephone | 6024945050 |
| Practice Fax Number | 6024942611 |
| Mailing Telephone | 6024945050 |
| Mailing Fax Number | 6024942611 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2011-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 19465 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 046591 | 05 |
| Street Address |
11209 N TATUM BLVD #255 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85028-3091 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124011713 | Thomas W Bauch | Family Medicine | 11209 N Tatum Blvd, 175, Phoenix, AZ 85028-3091 | 2005-08-29 |
| 1750837050 | Jennifer Billiard | Social Worker | 11209 N Tatum Blvd, #260, Phoenix, AZ 85028-6025 | 2016-08-28 |
| 1063861060 | Matthew Wisehart | Physical Therapist | 11209 N Tatum Blvd, Ste B-120, Phoenix, AZ 85028-3091 | 2016-06-09 |
| 1861862989 | Jennifer Anne Billingsley | Nurse Practitioner | 11209 N Tatum Blvd, Suite 255, Phoenix, AZ 85028 | 2015-10-01 |
| 1467876524 | Melisa Ann Curry | Physical Therapist | 11209 N Tatum Blvd, Ste B-120, Phoenix, AZ 85028-3091 | 2014-02-10 |
| 1114267887 | Allison M Gaylor | Nurse Practitioner | 11209 N Tatum Blvd, Suite 180, Phoenix, AZ 85028-3091 | 2013-02-18 |
| 1598011785 | Jessica Lynn Giddings | Nurse Practitioner | 11209 N Tatum Blvd, Suite 260, Phoenix, AZ 85028-3091 | 2012-07-25 |
| 1518119692 | Joanne L Schlesinger | Nurse Practitioner | 11209 N Tatum Blvd, Suite 260, Phoenix, AZ 85028-3091 | 2008-10-21 |
| 1295984987 | Sonya A Bladow | Chiropractor | 11209 N Tatum Blvd, Ste 140, Phoenix, AZ 85028-3091 | 2008-09-17 |
| 1114182888 | Rakesh Kumar Bagai | Internal Medicine | 11209 N Tatum Blvd, #260, Phoenix, AZ 85028-3091 | 2008-07-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235626565 | Celice Korsten | Psychologist | 11020 N. Tatum Blvd., Ste. 100, Phoenix, AZ 85028 | 2018-04-23 |
| 1720591605 | Michele Kaplan | Counselor | 11640 N Tatum Blvd #3096, Phoenix, AZ 85028 | 2017-11-14 |
| 1154840304 | Faustino M. Gonzalez, Md PC | Anesthesiology | 11811 N. Tatum Blvd, Suite 3031, Phoenix, AZ 85028 | 2017-09-19 |
| 1679092514 | Savior Palliative Care LLC | Family Medicine | 4530 E Shea Blvd Ste 175, Phoenix, AZ 85028 | 2017-09-12 |
| 1437688892 | Harmony Behavioral Health | Behavioral Analyst | 3008 E Sierra St, Phoenix, AZ 85028 | 2017-06-08 |
| 1275949224 | Alexander D Garza | Podiatrist | 3101 E Shea Blvd Ste 220, Phoenix, AZ 85028 | 2014-07-09 |
| 1720418379 | Alyssa Hale | Occupational Therapy Assistant | 4600 East Shea Boulevard, Suite 101, Phoenix, AZ 85028 | 2013-11-19 |
| 1932534476 | Stephen Howard Garber | Otolaryngology | 9607 N. 43rd Way, Phoenix, AZ 85028 | 2013-09-03 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1285930925 | Cathy Ann Payne | Nurse Practitioner | 11209 N Tatum Blvd Ste 260, Phoenix, AZ 85028 | 2011-01-27 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477050375 | Blue Ye Maya LLC | Obstetrics & Gynecology | 531 E Lynwood St Fl 2, Phoenix, AZ 85004-1626 | 2018-04-09 |
| 1659717924 | Kate E Maroney | Obstetrics & Gynecology | 1661 E Camelback Rd Ste 160, Phoenix, AZ 85016-3921 | 2013-05-14 |
| 1306281571 | Jeffrey Blake Higley | Obstetrics & Gynecology | 650 W Maryland Ave Ste 1, Phoenix, AZ 85013 | 2013-05-01 |
| 1033485511 | Sigrid Gardner Williams | Obstetrics & Gynecology | 4751 N 15th St, Phoenix, AZ 85014-3707 | 2012-03-28 |
| 1316263585 | Allison Amber Snyder | Obstetrics & Gynecology | 3811 E Bell Rd Ste 312, Phoenix, AZ 85032-2160 | 2010-04-13 |
| 1033348487 | Jill D Gibson | Obstetrics & Gynecology | 1313 E Osborn Rd Ste 250, Phoenix, AZ 85014-5699 | 2009-07-07 |
| 1083841969 | Laura T Mercer | Obstetrics & Gynecology | 500 W Thomas Rd Ste 720730, Phoenix, AZ 85013-4224 | 2009-06-17 |
| 1770710097 | Adriana Lea Pritchard | Obstetrics & Gynecology | 1300 North 12th Street, Suite 407, Phoenix, AZ 85006 | 2009-06-12 |
| 1033392113 | Chijioke Nnenna Soribe | Obstetrics & Gynecology | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2007-12-11 |
| 1013190420 | Neil Trachtenberg, M.d.,p.c. | Obstetrics & Gynecology | 300 W Clarendon Ave Ste 145, Phoenix, AZ 85013-3449 | 2007-12-07 |
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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.