Active NPI
Carmen Santiago, AU.D
- Audiologist
- Bronx, NY
National Provider Identifier
1043311046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 41YA00093300
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (718) 518-5659
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 00154 | NY | |
| Audiologist-Hearing Aid Fitter | 237600000X | 14000016742 | NY | |
| Audiologist | 231H00000X | 41YA00093300 | NJ | Primary |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
83 Algonquin Ave
Lincoln Park, NJ 07035-2204
Other practice location 1
75 E Northfield Rd
Livingston, NJ 07039-4532
Phone (973) 436-1435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2289958 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001534 | NY | MD | Behavioral Analyst |
| 41YA00093300 | NJ | MD | Audiologist |
| 00154 | NY | MD | Audiologist |
| 14000016742 | NY | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1043311046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 ALGONQUIN AVE",
"city": "LINCOLN PARK",
"state": "NJ",
"postal_code": "070352204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-518-5659"
}
],
"practiceLocations": [
{
"address_1": "75 E Northfield Rd",
"address_purpose": "LOCATION",
"city": "Livingston",
"state": "NJ",
"postal_code": "070394532",
"country_code": "US",
"telephone_number": "973-436-1435",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTIAGO",
"first_name": "CARMEN",
"name_prefix": "Dr.",
"credential": "AU.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "00154",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "NY",
"license": "14000016742",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NJ",
"license": "41YA00093300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2289958",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.