Individual provider Active NPI

Jose A Santiago, MD

  • Neurological Surgery Physician
  • Augusta, GA
National Provider Identifier
1083679252
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
056393 Issued in GA
Practice address
1 Freedom Way
VA Medical Center, Neurosurgery
Augusta, GA 30904-6258
Phone
(706) 733-0188
Fax
(706) 823-1751
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 056393 GA Primary
Neurological Surgery Physician 207T00000X 18840 SC
Neurological Surgery Physician 207T00000X G5572 TX
Neurological Surgery Physician 207T00000X MD425822 PA

Addresses

Primary practice location

1 Freedom Way
VA Medical Center, Neurosurgery
Augusta, GA 30904-6258

Mailing address

1 Freedom Way
VA Medical Center, Neurosurgery
Augusta, GA 30904-6258
Phone (706) 733-0188

Other identifiers 1

IdentifierTypeStateIssuer
T26120MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20050719000509 GA Practitioner - Neurosurgery 0042253536 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD425822PAMDNeurological Surgery Physician
G5572TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2005 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2005 Accepting new patients

Locations

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

410 University Pkwy
Ste 2360
Aiken, SC 29801
Phone (803) 642-6500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1083679252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "VA MEDICAL CENTER, NEUROSURGERY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "VA MEDICAL CENTER, NEUROSURGERY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "056393",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SC",
            "license": "18840",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "G5572",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD425822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T26120",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.