Active NPI 1679596712 Individual Practitioner Male Practitioner

John A Desanto

Internal Medicine • Fishers, IN

Professional Overview & Biography Verified Profile Summary

John Desanto is a registered healthcare professional specializing in Internal Medicine in Fishers, IN. Practice services are available at 13050 PARKSIDE DR STE 101 under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

13050 Parkside Dr Ste 101

Fishers, IN 460388247

Telephone 3176212290

Associated Practice Facility / Clinic

🏢 Your Wellness Choice Llc Facility NPI 1093269334

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Fishers, IN

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 23.0 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

29 Specialists

Practicing in Fishers, IN (2204 Statewide)

Telehealth Adoption Rate

27.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	319	237	$203.00	$118.76
99213 Established patient office or other outpatient visit, typically 15 minutes	182	150	$143.00	$83.87
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	160	160	$276.00	$120.15
G0008 Administration of influenza virus vaccine	93	91	$34.87	$30.10
G0444 Annual depression screening, 5 to 15 minutes	71	71	$43.00	$17.21
90662 Influenza vaccine split virus, preservative free	70	70	$98.00	$81.82
90480 Admn sarscov2 vacc 1 dose	66	62	$60.00	$40.13
91322 Sarscov2 vac 50 mcg/0.5ml im	66	62	$196.00	$152.11
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	61	40	$30.00	$21.26
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	58	55	$230.00	$161.95
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	38	28	$127.00	$49.50
83036 Hemoglobin A1C level	32	28	$31.00	$9.52
81003 Automated urinalysis test	29	26	$7.00	$2.20
93000 Routine ekg using at least 12 leads including interpretation and report	18	18	$40.00	$12.59
G0009 Administration of pneumococcal vaccine	16	16	$34.00	$30.10
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	15	$72.00	$52.33
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	15	15	$100.00	$75.81
99497 Advance care planning, first 30 minutes	15	15	$202.00	$76.71
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	15	15	$349.00	$68.88
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	13	13	$402.00	$266.08
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$395.00	$153.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	344	266	$180.09	$118.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	193	193	$276.00	$120.11
99213 Established patient office or other outpatient visit, typically 15 minutes	154	131	$127.55	$83.92
G0008 Administration of influenza virus vaccine	89	89	$34.79	$28.63
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	82	82	$100.00	$75.81
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	66	43	$30.00	$21.00
G0444 Annual depression screening, 5 to 15 minutes	61	61	$43.00	$17.02
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	41	40	$230.00	$163.06
81003 Automated urinalysis test	39	34	$7.00	$2.20
83036 Hemoglobin A1C level	30	26	$31.00	$9.52
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	27	$127.00	$48.54
93000 Routine ekg using at least 12 leads including interpretation and report	28	27	$40.00	$12.93
90480 Admn sarscov2 vacc 1 dose	27	27	$60.00	$36.76
91322 Sarscov2 vac 50 mcg/0.5ml im	26	26	$196.00	$143.00
0124A Fee covid-19 vac 13 res	25	25	$60.00	$38.17
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	24	16	$97.00	$38.27
G0009 Administration of pneumococcal vaccine	23	23	$34.00	$28.63
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	19	18	$349.00	$50.53
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$223.00	$130.80
90671 Pneumococcal conjugate vaccine, 15 valent (pcv15), for intramuscular use	11	11	$468.00	$241.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,160	30	$42.00	$21.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	315	242	$163.00	$120.22
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	188	188	$276.00	$121.87
99213 Established patient office or other outpatient visit, typically 15 minutes	174	140	$113.69	$84.39
99335 Established patient assisted living visit, typically 25 minutes	116	54	$143.00	$89.35
G0008 Administration of influenza virus vaccine	105	105	$34.90	$27.29
90662 Influenza vaccine split virus, preservative free	95	95	$98.00	$68.47
0054A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, tris-sucrose formulation; booster dose	69	67	$60.00	$36.48
0124A Fee covid-19 vac 13 res	56	56	$60.00	$36.16
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	55	36	$97.00	$37.79
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	49	32	$60.00	$13.40
83036 Hemoglobin A1C level	44	39	$31.00	$9.60
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	40	38	$127.00	$49.13
93000 Routine ekg using at least 12 leads including interpretation and report	32	31	$40.00	$12.99
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	25	13	$30.00	$21.42
99336 Established patient assisted living visit, typically 40 minutes	25	21	$203.00	$126.42
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	23	$227.71	$170.00
G0009 Administration of pneumococcal vaccine	22	22	$34.00	$27.46
81003 Automated urinalysis test	22	21	$7.00	$2.21
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	21	20	$349.00	$30.59
90670 Pneumococcal vaccine for injection into muscle	13	13	$468.00	$230.45
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$395.00	$155.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$71.00	$52.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,700	33	$42.00	$20.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	341	250	$163.00	$122.18
99213 Established patient office or other outpatient visit, typically 15 minutes	213	170	$109.00	$85.95
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	177	177	$276.00	$125.00
G0008 Administration of influenza virus vaccine	149	148	$34.54	$15.83
90662 Influenza vaccine split virus, preservative free	115	114	$98.00	$64.58
99335 Established patient assisted living visit, typically 25 minutes	97	42	$143.00	$90.53
0003A Adm sarscov2 30mcg/0.3ml 3rd	63	63	$60.00	$37.21
99443 Telephone medical discussion with physician, 21-30 minutes	52	49	$163.00	$122.81
83036 Hemoglobin A1C level	49	40	$31.00	$9.71
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	45	33	$60.00	$13.32
93000 Routine ekg using at least 12 leads including interpretation and report	40	37	$40.00	$13.79
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	35	35	$62.00	$29.92
99442 Telephone medical discussion with physician, 11-20 minutes	34	28	$109.00	$86.40
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	32	30	$219.00	$171.45
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	32	16	$30.00	$20.70
99336 Established patient assisted living visit, typically 40 minutes	30	22	$203.00	$128.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	21	$66.00	$50.83
G0009 Administration of pneumococcal vaccine	19	19	$34.00	$15.84
81003 Automated urinalysis test	17	16	$7.00	$2.25
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	15	14	$180.00	$35.33
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$408.00	$159.10
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	14	14	$223.00	$124.63
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$395.00	$159.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,740	26	$42.00	$19.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	289	199	$163.00	$102.58
99213 Established patient office or other outpatient visit, typically 15 minutes	190	158	$109.00	$70.89
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	164	164	$276.00	$109.64
99442 Telephone medical discussion with physician, 11-20 minutes	155	116	$109.00	$70.31
99335 Established patient assisted living visit, typically 25 minutes	153	46	$143.00	$92.02
99443 Telephone medical discussion with physician, 21-30 minutes	125	103	$163.00	$102.44
G0008 Administration of influenza virus vaccine	75	75	$27.16	$15.86
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	72	61	$127.00	$50.37
90662 Influenza vaccine split virus, preservative free	68	68	$98.00	$60.98
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	46	20	$97.00	$38.57
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	34	28	$60.00	$13.47
99336 Established patient assisted living visit, typically 40 minutes	32	22	$203.00	$129.65
G0009 Administration of pneumococcal vaccine	26	26	$34.00	$15.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$66.00	$42.64
93000 Routine ekg using at least 12 leads including interpretation and report	17	17	$40.00	$15.30
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$223.00	$116.72
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$408.00	$162.44
99441 Telephone medical discussion with physician, 5-10 minutes	13	12	$66.00	$42.72
83036 Hemoglobin A1C level	12	12	$31.00	$9.71
90670 Pneumococcal vaccine for injection into muscle	12	12	$468.00	$221.89
81003 Automated urinalysis test	11	11	$7.00	$2.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	3,660	34	$42.00	$18.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	626	305	$163.00	$102.88
99213 Established patient office or other outpatient visit, typically 15 minutes	264	186	$109.00	$69.97
99335 Established patient assisted living visit, typically 25 minutes	237	49	$143.00	$91.14
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	231	231	$276.00	$110.23
G0008 Administration of influenza virus vaccine	131	131	$34.00	$15.55
90653 Vaccine for influenza for injection into muscle	125	125	$101.00	$58.34
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	80	41	$97.00	$38.94
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	72	36	$60.00	$15.78
81002 Urinalysis, manual test	67	52	$8.00	$3.41
99336 Established patient assisted living visit, typically 40 minutes	57	28	$203.00	$129.68
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	57	49	$127.00	$50.35
G0009 Administration of pneumococcal vaccine	49	49	$34.00	$15.55
93000 Routine ekg using at least 12 leads including interpretation and report	38	37	$40.00	$15.91
90670 Pneumococcal vaccine for injection into muscle	27	27	$468.00	$210.28
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	22	22	$223.00	$111.35
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$249.00	$155.60
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	18	18	$395.00	$158.31
99496 Transitional care management services for problem of high complexity	15	12	$349.00	$219.61
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	12	12	$40.00	$15.95
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$408.00	$163.04
99326 New patient assisted living visit, typically 45 minutes	11	11	$210.00	$133.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	3,060	33	$42.00	$17.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	525	276	$163.00	$101.60
99335 Established patient assisted living visit, typically 25 minutes	348	128	$143.00	$90.10
99213 Established patient office or other outpatient visit, typically 15 minutes	321	230	$109.00	$68.60
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	215	215	$276.00	$109.68
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	181	113	$97.00	$39.19
G0008 Administration of influenza virus vaccine	135	128	$34.00	$19.10
90653 Vaccine for influenza for injection into muscle	124	117	$101.00	$52.83
99336 Established patient assisted living visit, typically 40 minutes	118	74	$203.00	$128.53
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	63	36	$60.00	$19.23
81002 Urinalysis, manual test	49	42	$8.00	$3.41
93000 Routine ekg using at least 12 leads including interpretation and report	46	44	$40.00	$15.75
G0009 Administration of pneumococcal vaccine	34	34	$34.00	$19.09
99334 Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes	25	23	$91.00	$57.33
90670 Pneumococcal vaccine for injection into muscle	19	19	$468.00	$197.15
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$223.00	$105.59
99326 New patient assisted living visit, typically 45 minutes	15	15	$210.00	$132.55
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	14	$66.00	$41.16
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	14	14	$62.00	$21.89
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$395.00	$157.11
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$408.00	$161.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99335 Established patient assisted living visit, typically 25 minutes	513	145	$143.00	$90.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	510	263	$163.00	$101.24
99213 Established patient office or other outpatient visit, typically 15 minutes	295	228	$109.00	$68.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	224	224	$276.00	$108.87
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	186	94	$97.00	$38.92
G0008 Administration of influenza virus vaccine	161	159	$33.89	$23.63
90653 Vaccine for influenza for injection into muscle	136	136	$101.00	$49.22
99336 Established patient assisted living visit, typically 40 minutes	110	67	$203.00	$128.54
G0009 Administration of pneumococcal vaccine	104	104	$34.00	$23.63
90670 Pneumococcal vaccine for injection into muscle	68	68	$468.00	$180.78
81002 Urinalysis, manual test	64	58	$8.00	$3.43
93000 Routine ekg using at least 12 leads including interpretation and report	46	43	$40.00	$15.78
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	37	37	$223.00	$91.42
99334 Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes	27	26	$91.00	$57.49
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	23	23	$62.00	$22.55
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	22	22	$408.00	$161.22
99326 New patient assisted living visit, typically 45 minutes	13	13	$210.00	$132.91

Medical Specialties & State Licenses

CMS Verified: 2026-06-24

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License IN 01038336A

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

100354250 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Cheryl Shutes , FNP

Nurse Practitioner - Family

NPI 1255383113

Family Nurse Practitioner

Janelle Kieck

Nurse Practitioner

NPI 1417482019

Allie Carson , NP

Nurse Practitioner

NPI 1619922150

Nurse Practitioner

Dr. Daniel Wikse , MD

Family Medicine

NPI 1770595357

Doctor of Medicine (M.D.)

Dr. David Vickery , MD

Family Medicine

NPI 1790707867

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Business Mailing Address June 24, 2026

Registered at 6626 E 75TH ST STE 500, INDIANAPOLIS, IN 462502890 (Tel: 3173552184)

📍

Updated Practice Location December 26, 2024

Registered at 13050 PARKSIDE DR STE 101, FISHERS, IN 460388247 (Tel: 3176212290)

✅

NPI Profile Active January 31, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location January 31, 2017

Registered at 10122 E 10TH ST, SUITE 220, INDIANAPOLIS, IN 462292664 (Tel: 3173552200)

📍

Updated Business Mailing Address January 31, 2017

Registered at 6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 462502890 (Tel: 3173552184)

👤

Provider Name / Credentials Updated January 31, 2017

Recorded as JOHN DESANTO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2017

Internal Medicine (License #01038336A in IN)

✅

NPI Profile Active March 05, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location March 05, 2015

Registered at 10122 E 10TH ST, SUITE 220, INDIANAPOLIS, IN 462292664 (Tel: 3173552200)

📍

Updated Business Mailing Address March 05, 2015

Registered at 6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 462502890 (Tel: 3173552184)

👤

Provider Name / Credentials Updated March 05, 2015

Recorded as JOHN DESANTO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2015

Internal Medicine (License #01038336A in IN)

🟢

Initial NPI Registration & Enumeration July 26, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1679596712

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 26, 2006

Last Update: June 24, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6626 E 75th St Ste 500

Indianapolis, IN 462502890

Phone: 3173552184

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.