NPIMap

Individual provider Active NPI

Alexandra Santiago-Vazquez

  • Infectious Disease Physician
  • Sacramento, CA
National Provider Identifier
1053623520
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
151454 Issued in CA
Practice address
1500 21St St
Sacramento, CA 95811-5216
Phone
(916) 443-3299
NPI assigned
Jul 13, 2010
Last updated
Dec 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 151454 CA Primary
Infectious Disease Physician 207RI0200X 020638 PR

Addresses

Primary practice location

1500 21St St
Sacramento, CA 95811-5216

Mailing address

1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299

Other practice location 1

6 Calle jose De Diego
Anexo Antig Alcaldia
Carolina, PR 00986
Phone (787) 340-3795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150922001914 PR Practitioner - Infectious Disease 0941517098 Practice locations: Carolina, PR
I20220118001202 NC Practitioner - Infectious DiseasePractitioner - Internal Medicine 0941517098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1225 Harding PL
Charlotte, NC 28204-2826

1237 Harding PL
Suite 3200
Charlotte, NC 28204-2826
Phone (704) 446-3040

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151454CAMDInfectious Disease Physician
020638PRMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 15, 2022 Accepting new patients
Carolinas Physicians Network Inc Multi-Specialty CurrentSince Jan 15, 2022 Accepting new patients
Carolinas Physicians Network Inc Multi-Specialty Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 15, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Multi-Specialty Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jan 15, 2022 Accepting new patients
Carolinas Physicians Network, Inc Multi-Specialty Past Accepting new patients

Locations

1225 Harding Pl
Ste 2100
Charlotte, NC 28204
Phone (704) 331-9669

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

200 Medical Park Dr
Ste 280
Concord, NC 28025
Phone (704) 403-1766

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1053623520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 21ST ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115216",
            "telephone_number": "916-443-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Calle jose De Diego",
            "address_2": "Anexo Antig Alcaldia",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "00986",
            "country_code": "US",
            "telephone_number": "787-340-3795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO-VAZQUEZ",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "151454",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PR",
            "license": "020638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.