Individual provider Active NPI

Aldrin Marcus Santamaria, OD

  • Optometrist
  • Forest Grove, OR
National Provider Identifier
1073207023
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1475 Issued in ZZ
Practice address
2043 College Way
Forest Grove, OR 97116-1756
Phone
(503) 352-2020
NPI assigned
Jun 5, 2023
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1475 ZZ Primary

Addresses

Primary practice location

2043 College Way
Forest Grove, OR 97116-1756

Mailing address

305-9225 93 Ave
Grande Prairie, ALBERTA T8V4G1
CA

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

State licenses

LicenseStateTypeSpecialty
1475ZZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1073207023",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "305-9225 93 AVE",
            "city": "GRANDE PRAIRIE",
            "state": "ALBERTA",
            "postal_code": "T8V4G1"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAMARIA",
        "first_name": "ALDRIN",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ZZ",
            "license": "1475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.