Individual provider Active NPI

Jaime Allan Santi

  • Family Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1043508203
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704255570 Issued in MI
Practice address
440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone
(906) 776-9040
Fax
(906) 774-7279
NPI assigned
Jul 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704255570 MI Primary

Addresses

Primary practice location

440 Woodward Ave
Iron Mountain, MI 49801-4631

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110930000132 MI Practitioner - Nurse Practitioner 4486826187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704255570MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince Aug 3, 2021 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Aug 3, 2021 Accepting new patients
Oconto Hospital & Medical Center, Inc. Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 1, 2016 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1100 10th St
Menominee, MI 49858
Phone (906) 863-2256

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

Interoperability endpoints

  • Direct secure messaging: jsanti66750@direct.thedacare.org
  • Direct secure messaging: jsanti925540@direct.emplifyhealth.org

Organizations & group practices 6

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 5

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1043508203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTI",
        "first_name": "JAIME",
        "middle_name": "ALLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704255570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.