GINO DESANTIS (PA-C) – Physician Assistant, NPI 1114016995

GINO DESANTIS (PA-C) is a healthcare provider. based in Woburn, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. MA052388 (PA). The NPI Number for GINO DESANTIS (PA-C) is 1114016995

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
GINO DESANTIS (PA-C)
NPI
1114016995
Phone
(781) 937-4522
Address
12 GILL ST
Enumeration Date
12 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6109440464
Graduation Year
2004 (22 years ago)
PAC ID
8022176270
Group Practice PAC ID
1658289517
Professional Enrollment ID
I20081027000310
Address ID
PA195597706ST44XXXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,691 PHYSICIAN ASSISTANT in PA

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Provider Addresses for GINO DESANTIS (PA-C)

  • 12, Gill Street, Mishawum, Woburn, Middlesex County, Massachusetts, 01801, United States

    STE 3000

    WOBURN, MA 018011728

    Phone: (781) 937-4522

    Type: Mailing

  • DeKalb Pike, Norristown, Montgomery County, Pennsylvania, 19401, United States

    NORRISTOWN, PA 194011820

    Phone: (610) 278-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-10-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081027000310IPhysician AssistantPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658289517View full group profile
NameSpecialtyState
Physician AssistantPA
Physician AssistantPA
Physician AssistantPA
-PA
Physician AssistantUT
Family Practice, HospitalistPA
Physician AssistantPA
Physician AssistantPA
-PA
Family PracticePA

Reviews

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Frequently asked questions

What federal number belongs to GINO DESANTIS (PA-C)?
The federal identifier for GINO DESANTIS (PA-C) is NPI 1114016995.
Is GINO DESANTIS (PA-C) currently active in the NPI registry?
CMS-published data lists GINO DESANTIS (PA-C) as an active registrant.
What kind of provider is GINO DESANTIS (PA-C)?
The page reflects Physician Assistant for GINO DESANTIS (PA-C). Clinical services aligned with this taxonomy classification.
What location shows for GINO DESANTIS (PA-C)?
We surface Woburn, Massachusetts for GINO DESANTIS (PA-C) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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