Santiago Jimenez, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME94727 Issued in FL

Practice address

1223 Gateway Dr
Melbourne, FL 32901-2607

Phone

(321) 549-0677

NPI assigned

Nov 17, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, AL, OH, SC, TX, IL, FL, PA, NJ, CT, MI, WI12 enrollments

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 12

Specialty

Diagnostic Radiology

Education

Ponce School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reono Bertagnolli a Medical Group 47 clinicians

Community Mobile Ultrasound LLC 16 clinicians

Community Mobile Diagnostics LLC 9 clinicians

Health First Medical Group, LLC 701 clinicians

Brevard Physician Associates PLLC 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Viera Hospital Hospital, Melbourne, FL, CCN 100315
• Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
• Palm Bay Hospital Hospital, Palm Bay, FL, CCN 100316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjimenez71509@epicdirect.hf.org

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.

• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955

  Diagnostic Radiology, FL

  Medicare reassignment Care Compare group NPD
• Health First Medical Group, LLC

  • General Practice Physician
  • Melbourne, FL
  • NPI 1750626495

  Diagnostic Radiology, FL

  Medicare reassignment Care Compare group NPD
• Community Mobile Diagnostics LLC

  • Diagnostic Radiology Physician
  • San Leandro, CA
  • NPI 1023104007

  FL, GA, IL, TX

  Medicare reassignment Care Compare group
• Community Mobile Ultrasound, LLC

  • Diagnostic Ultrasound Physician
  • Oceanside, CA
  • NPI 1760620959

  FL, GA, IL, TX

  Medicare reassignment Care Compare group
• Reono Bertagnolli a Medical Group

  • Diagnostic Radiology Physician
  • San Leandro, CA
  • NPI 1134424005

  AL, CT, FL, GA, IL, MI, NJ, OH, PA, SC, TX, WI

  Medicare reassignment Care Compare group
• State of New Jersey Omb Centralized Payroll

  • Psychiatric Hospital
  • Trenton, NJ
  • NPI 1467552240

  NJ

  Medicare reassignment NPD
• Health First Medical Group, LLC

  • General Practice Physician
  • Rockledge, FL
  • NPI 1073268934
  Care Compare group NPD
• American Diagnostics Services LLC

  • Physiological Laboratory
  • Windsor Mill, MD
  • NPI 1639140387

  FL, IL, TX

  Medicare reassignment
• Kan-Di-Ki LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • North Hollywood, CA
  • NPI 1750364345

  FL, IL, NJ, TX

  Medicare reassignment
• Kan-Di-Ki, LLC

  • Diagnostic Ultrasound Physician
  • North Hollywood, CA
  • NPI 1548422488

  AL, OH

  Medicare reassignment
• Symphony Diagnostic Services No 1 LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Hunt Valley, MD
  • NPI 1700865094

  FL, NJ, TX

  Medicare reassignment
• Health First Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Melbourne, FL
  • NPI 1831738392
  Care Compare group

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

• Cape Canaveral Hospital, Inc.

  • General Acute Care Hospital
  • Cocoa Beach, FL
  • NPI 1184691610

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Palm Bay, FL
  • NPI 1386940823

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728

  Hospital

  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1073595740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-549-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-549-0677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5166 Lowing Ct",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329557002",
            "country_code": "US",
            "telephone_number": "913-435-5806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SANTIAGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "BP10024058",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME94727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hong Sun Jeong, MD
• Jeroll Care Assisted Living Facility of Melbourne, LLC
• JGN Investments LLC
• Kaysha Jimenez
• Roxana Jimenez
• Kraig Jinwright
• Michael Joseph Jiordano, PHARMACY TECHNICIAN
• JJL Healthcare Services
• JM Holdings of Brevard Inc
• Elaina Joanou

• All providers in Melbourne, FL
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.
• 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.