Active NPI
Joaquin F Santillan, MPT
- Physical Therapist
- Santa Teresa, NM
National Provider Identifier
1003985565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4955
- Practice address
- 103 Livingston Loop
Suite B1
Santa Teresa, NM 88008-9747 - Phone
- (575) 587-7061
- Fax
- (915) 493-8264
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1104438 | TX | |
| Physical Therapist | 225100000X | 4955 | NM | Primary |
Addresses
Primary practice location
103 Livingston Loop
Suite B1
Santa Teresa, NM 88008-9747
Mailing address
4849 N Mesa St Ste 201
El Paso, TX 79912-5919
Phone (915) 351-6600
Other practice location 1
5360 N Mesa St Ste A1
El Paso, TX 79912-5820
Phone (915) 613-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
103 Livingston Loop
Suite B1
Santa Teresa, NM 88008-9747
Phone (575) 587-7061
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4955 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Wellness and Rehab, P.L.L.C | Physical Therapist | Current | Accepting new patients |
| Matrix Rehabilitation Ohio, Inc. | Past | Accepting new patients |
Locations
103 Livingston Loop
Ste B1
Santa Teresa, NM 88008
Phone (575) 332-4246
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Santa Teresa, NM
- NPI 1649528951
-
- Rehabilitation Clinic/Center
- Akron, OH
- NPI 1336173335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1003985565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4849 N MESA ST STE 201",
"city": "EL PASO",
"state": "TX",
"postal_code": "799125919",
"telephone_number": "915-351-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 LIVINGSTON LOOP",
"address_2": "SUITE B1",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "880089747",
"telephone_number": "575-587-7061",
"fax_number": "915-493-8264"
}
],
"practiceLocations": [
{
"address_1": "5360 N Mesa St Ste A1",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799125820",
"country_code": "US",
"telephone_number": "915-613-2000",
"fax_number": "915-613-4900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTILLAN",
"first_name": "JOAQUIN",
"middle_name": "F",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1104438",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Teresa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.