NPIMap

Individual provider Active NPI

Jose M. R. Santos, M.D.

  • Nephrology Physician
  • Modesto, CA
National Provider Identifier
1073577573
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A52954 Issued in CA
Practice address
608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone
(209) 529-2645
Fax
(209) 529-3024
NPI assigned
Apr 13, 2006
Last updated
Feb 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A52954 CA Primary

Addresses

Primary practice location

608 E Orangeburg Ave
Modesto, CA 95350-5513

Mailing address

608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone (209) 529-2645

Other identifiers 2

IdentifierTypeStateIssuer
GR0099870MedicaidCA
00A529540MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050825000840 CA Practitioner - Nephrology 0749273753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Nephrology AssociatesGroup PAC ID 6709870330, 3 clinicians

Practice addresses (Care Compare)

1729 N Olive Ave
Suite 11
Turlock, CA 95382-2501
Phone (209) 664-0410

608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone (209) 529-2645

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52954CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Nephrology Associates CurrentSince Aug 1, 2003 Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Dameron Hospital Association Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Doctors Hospital of Manteca, Inc. Past Accepting new patients

Locations

1140 Norman Dr
Ste 4
Manteca, CA 95336
Phone (209) 823-3158

1144 Norman Dr
Ste 203
Manteca, CA 95336
Phone (209) 405-2406

1315 10th St
Ste 200
Modesto, CA 95354
Phone (209) 529-2645

608 E Orangeburg Ave
Modesto, CA 95350
Phone (209) 529-2645

136 Columbia Way
Sonora, CA 95370
Phone (209) 532-3072

1729 N Olive Ave
Ste 11
Turlock, CA 95382
Phone (209) 664-0410

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73255
  • Direct secure messaging: josesantos@vna.allscriptsdirect.net
  • Direct secure messaging: jsantos53150@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1073577573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505513",
            "telephone_number": "209-529-2645",
            "fax_number": "209-529-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505513",
            "telephone_number": "209-529-2645",
            "fax_number": "209-529-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JOSE",
        "middle_name": "M. R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A52954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099870",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A529540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.