Individual provider Active NPI

Ismael Dean Santiago, PHARMD

  • Pharmacist
  • San Juan, PR
National Provider Identifier
1083328108
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
008002 Issued in PR
Practice address
282 Ave Jesus T Pinero
San Juan, PR 00927-3921
Phone
(787) 705-7404
NPI assigned
Jan 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 008002 PR Primary

Addresses

Primary practice location

282 Ave Jesus T Pinero
San Juan, PR 00927-3921

Mailing address

1239 Bulevar San Luis
Coto Laurel, PR 00780-2246
Phone (787) 672-4287

Other identifiers 2

IdentifierTypeStateIssuer
1463197OtherPRNATIONAL ASSOCIATION BOARDS OF PHARMACY
008002OtherPRPUERTO RICO PHARMACY LICENSE

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
008002PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1083328108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 BULEVAR SAN LUIS",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802246",
            "telephone_number": "787-672-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 AVE JESUS T PINERO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009273921",
            "telephone_number": "787-705-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ISMAEL",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "008002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ASSOCIATION BOARDS OF PHARMACY",
            "identifier": "1463197",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUERTO RICO PHARMACY LICENSE",
            "identifier": "008002",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.