Organization Active NPI

Celestino Santi DO PA

  • Internal Medicine Physician
  • Tavares, FL
National Provider Identifier
1043438161
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS5119 Issued in FL
Legal business name
CELESTINO SANTI DO PA
Practice address
1300 E Burleigh Blvd
Tavares, FL 32778-4305
Phone
(352) 742-1500
Fax
(352) 742-2530
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Dr. Celestino David Santi, DONPI 1164427332
Title
Physician
Phone
(352) 742-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS5119 FL Primary

Addresses

Primary practice location

1300 E Burleigh Blvd
Tavares, FL 32778-4305

Mailing address

1300 E Burleigh Blvd
Tavares, FL 32778-4305
Phone (352) 742-1500

Other identifiers 1

IdentifierTypeStateIssuer
062412800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121004000161 FL Part B Supplier - Clinic/Group Practice 7911156153 Receives reassigned benefits from 1 practitioner
Practice locations: Tavares, FL

National Provider Directory

National Provider Directory

Locations

2020 Nightingale Ln
Tavares, FL 32778
Phone (352) 508-5254

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1043438161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BURLEIGH BLVD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784305",
            "telephone_number": "352-742-1500",
            "fax_number": "352-742-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BURLEIGH BLVD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784305",
            "telephone_number": "352-742-1500",
            "fax_number": "352-742-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELESTINO SANTI DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "SANTI",
        "authorized_official_first_name": "CELESTINO",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "352-742-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS5119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062412800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.