Individual provider Active NPI

Geno Anthony Santangelo Jr., P.A.-C

  • Surgical Physician Assistant
  • South Charleston, WV
National Provider Identifier
1013331271
Registry record updated Feb 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
00491 Issued in WV
Practice address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone
(304) 389-7914
NPI assigned
Feb 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 00491 WV Primary

Addresses

Primary practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Mailing address

716 Plantation Dr
Hurricane, WV 25526-9155
Phone (304) 389-7914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150114000075 WV Practitioner - Physician Assistant 5890019244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

Hospital & facility affiliations

  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391904000000",
    "number": "1013331271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 PLANTATION DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269155",
            "telephone_number": "304-389-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-389-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANGELO",
        "first_name": "GENO",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-09",
        "last_updated": "2014-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "00491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.