Individual provider Active NPI

Jose F Santiago, MD

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1023121613
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J3408 Issued in TX
Practice address
2624 W William Cannon Dr
Austin, TX 78745-5251
Phone
(512) 443-7746
Fax
(512) 443-6367
NPI assigned
Aug 16, 2006
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X J3408 TX
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X J3408 TX
Family Medicine Physician 207Q00000X 007936 PR
Family Medicine Physician 207Q00000X J3408 TX Primary

Addresses

Primary practice location

2624 W William Cannon Dr
Austin, TX 78745-5251

Mailing address

2624 W William Cannon Dr
Austin, TX 78745-5251
Phone (512) 443-7746

Other identifiers 2

IdentifierTypeStateIssuer
133386605MedicaidTX
133386601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091209000713 TX Practitioner - Family Practice 1658410337 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2624 W William Cannon Dr
Austin, TX 78745-5251
Phone (512) 443-7746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
007936PRMDFamily Medicine Physician
J3408TXMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1023121613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455251",
            "telephone_number": "512-443-7746",
            "fax_number": "512-443-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455251",
            "telephone_number": "512-443-7746",
            "fax_number": "512-443-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JOSE",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3408",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "J3408",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "007936",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J3408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133386605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133386601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.