NPIMap

Individual provider Active NPI

Angienelly Santiago, M.D., M.P.H

  • General Practice Physician
  • Corozal, PR
National Provider Identifier
1053554436
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17515 Issued in PR
Practice address
Bo. Mavillas Carr 159 KM 17.4 Int
Corozal, PR 00783
Phone
(787) 633-3390
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17515 PR Primary

Addresses

Primary practice location

Bo. Mavillas Carr 159 KM 17.4 Int
Corozal, PR 00783

Mailing address

PO Box 256
Corozal, PR 00783-0256
Phone (787) 633-3390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112001777 PR Practitioner - General Practice 8022328574 Reassigns benefits to 1 organization
Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Integral En la Montana Inc 64 clinicians

Practice addresses (Care Compare)

Carr 891 KM
1 Bo Pueblo
Corozal, PR 00783-2441
Phone (787) 859-2560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17515PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc. CurrentSince Oct 10, 2018 Accepting new patients
Salud Integral En la Montana, Inc General Practice CurrentSince Oct 10, 2018 Accepting new patients

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1053554436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007830256",
            "telephone_number": "787-633-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO. MAVILLAS CARR 159 KM 17.4 INT",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-633-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ANGIENELLY",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corozal, PR

Sources for this page

Verify at the official NPI Registry.