Active NPI
Gwenn Santoro, M.D.
- Pediatrics Physician
- Tucson, AZ
National Provider Identifier
1053847772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 63219
- Practice address
- 1925 W Orange Grove Rd Ste 302
Tucson, AZ 85704-1152 - Phone
- (520) 797-3888
- Fax
- (520) 797-2196
- NPI assigned
- May 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 63219 | AZ | Primary |
| Pediatrics Physician | 208000000X | 304857-01 | NY |
Addresses
Primary practice location
1925 W Orange Grove Rd Ste 302
Tucson, AZ 85704-1152
Mailing address
219 Anderson PL
Buffalo, NY 14222-1803
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63219 | AZ | MD | Pediatrics Physician |
| 304857-01 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1053847772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 ANDERSON PL",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142221803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 W ORANGE GROVE RD STE 302",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857041152",
"telephone_number": "520-797-3888",
"fax_number": "520-797-2196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTORO",
"first_name": "GWENN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-02",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "63219",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "304857-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.