Alexander Fernando San Diego Jr., D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3686 Issued in FL

Practice address

2404 N Courtenay Pkwy
Merritt Island, FL 32953-4191

Phone

(321) 452-1327

Fax

(321) 454-9208

NPI assigned

Apr 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, MO, WI, IL, CO, GA, TN, AL8 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 8

Specialty

Podiatry

Education

Ohio State University College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.82 of 100Reported as group

Quality

72.99

Improvement activities

40

Cost

75.6

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Preferred Podiatry Group PC

  • Podiatrist
  • Oak Harbor, WA
  • NPI 1720037138

  CO, FL, GA, IL, MO, TN, WI

  Medicare reassignment Care Compare group
• Merritt Island Foot & Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Merritt Island, FL
  • NPI 1427236199
  Medicare reassignment NPD
• Asdj LLC

  • Foot & Ankle Surgery Podiatrist
  • Rockledge, FL
  • NPI 1306457841
  NPD Authorized official
• Preferred Podiatry Group PC

  • Podiatrist
  • Chicago, IL
  • NPI 1316360613
  NPD

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1053678052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534191",
            "telephone_number": "321-452-1327",
            "fax_number": "321-454-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534191",
            "telephone_number": "321-452-1327",
            "fax_number": "321-454-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN DIEGO",
        "first_name": "ALEXANDER",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1053678052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13574563",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surobhi Saikia, M.A,,
• Roderick Henry Salach, D.O.
• Alfreda Salter
• Salus Beachside LLC
• Jacqueline Lent Samani, RN
• Sally Harris Sange, M.D.
• Camille Marie Santarpio, D.O.
• Peter Anthony Santisi, OD
• Patricia Susan Santos, MPT
• Ashley Santus

• Foot & Ankle Surgery Podiatrist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.