| James M Desantis, MD | |
|
400 Westpark Ct, Ste 230, Peachtree City, GA 30269-3571 | |
| (770) 631-8478 | |
| (770) 631-8473 |
| Full Name | James M Desantis |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 44 Years |
| Location | 400 Westpark Ct, Peachtree City, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659326650 | NPI | - | NPPES |
| 4295661 | Other | AL | AETNA |
| 10577706 | Other | CAQH | |
| 009912277 | Medicaid | AL | |
| 051542232 | Other | AL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 25650 (Alabama) | Secondary |
| 207P00000X | Emergency Medicine | MD027124E (Pennsylvania) | Secondary |
| 207P00000X | Emergency Medicine | P1452 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hospital | Dumas, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Moore County Hospital District | 1254226269 | 35 |
| Entity Name | Moore County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700991700 PECOS PAC ID: 1254226269 Enrollment ID: O20040430000610 |
| Entity Name | Concord Medical Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083630610 PECOS PAC ID: 0446296818 Enrollment ID: O20050707000531 |
| Entity Name | Concord Medical Group Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750790762 PECOS PAC ID: 7810117223 Enrollment ID: O20141007002567 |
| Mailing Address | Practice Location Address |
|---|---|
| James M Desantis, MD 10247 Highway 92, Apt 402, Woodstock, GA 30188-3914 Ph: (678) 361-3028 | James M Desantis, MD 400 Westpark Ct, Ste 230, Peachtree City, GA 30269-3571 Ph: (770) 631-8478 |
Mrs. Laura Noel Moore, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Line Creek Dr, Peachtree City, GA 30269 Phone: 770-847-8786 | |
Christi Lee Mccleery, PA-C Emergency Medicine Medicare: Medicare Enrolled Practice Location: 529 Pinegate Rd, Peachtree City, GA 30269 Phone: 786-548-1960 |