Israel Duran Santibanez, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

78697 Issued in CT

Practice address

90 S Main St Ste 201
Middletown, CT 06457-3649

Phone

(860) 358-6486

NPI assigned

Mar 21, 2023

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

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1073215224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST STE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST STE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN SANTIBANEZ",
        "first_name": "ISRAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "78697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna M Duer, APRN
• Christine L Duncan, RN
• Pamela Duncan
• Sabrina Dunchie
• Susan Hurley Dunn, PT MBA
• Judith Durdan, LCSW
• Stacey Durr, APRN
• Harsha V Duvvi, MD
• Denice B, Dwyer, RNC-E
• Byron Roy Easterly

• Student in an Organized Health Care Education/Training Program in Middletown, CT
• Providers in Middletown, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.