Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark Desantis, DO

Individual provider Body Imaging Physician · NPI 1053424192

Dr. Mark Desantis, DO is a Diagnostic Radiology in Northport, New York. Qualified in 1993, 33 years ago. Practices with Riverside Medical Clinic Inc, a 174-clinician group and accepts Medicare assignment. Licensed in Florida and New Jersey.

Years since qualifying
33
Licensed in
FL, NJ
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

79 Middleville Rd
Northport, NY 11768
Phone: (631) 261-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Body Imaging Physician (primary) Taxonomy 2085B0100X · Licence 25MB08021500 (NJ)
Nuclear Medicine Physician Taxonomy 207U00000X · Licence OS10292 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence OS10292 (FL)

Record details

NPI number1053424192
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 15, 2006
Last updated in NPPESJune 11, 2026
Certification dateJune 11, 2026
Mailing address79 Middleville Rd, Northport, NY 11768-2200

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Riverside Medical Clinic Inc — 174 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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