Elenita P Santos-Mata, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

07399R Issued in LA

Practice address

4851 W Park Dr
Suite a
Zachary, LA 70791-4010

Phone

(225) 658-7636

Fax

(225) 658-7634

NPI assigned

Feb 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zachary Pediatrics

  • Legal Medicine
  • Zachary, LA
  • NPI 1194986893
  NPD (past) Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053454108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 W PARK DR",
            "address_2": "SUITE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914010",
            "telephone_number": "225-658-7636",
            "fax_number": "225-658-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 W PARK DR",
            "address_2": "SUITE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914010",
            "telephone_number": "225-658-7636",
            "fax_number": "225-658-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS-MATA",
        "first_name": "ELENITA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "LA",
            "license": "07399R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1372617",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristopher Neil Ruebsamen, D.D.S.
• Ryan Phillips LPC, L.L.C.
• Darren Keith Ryland, LMT
• Francisco Jose Sanfiel, MD
• Courtney Romero Sanford, M.S., CCC, SLP
• Bikal Sapkota, M.D
• Katie Karr Schexnayder, O.T.
• SCHS- Youth Mobile Crisis Services Zach
• Juanita Scott
• Lucy Scott

• Pediatric Adolescent Medicine Physician in Zachary, LA
• Providers in Zachary, LA by specialty
• Pediatric Adolescent Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.