Active NPI
Dereck Norberto Santiago, CRNA
- Certified Registered Nurse Anesthetist
- Manati, PR
National Provider Identifier
1104584358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 11006883
- Practice address
- Calle Hernandez Carrion
Manati, PR 00674 - Phone
- (787) 621-3700
- NPI assigned
- Dec 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 11006883 | FL | Primary |
Addresses
Primary practice location
Calle Hernandez Carrion
Manati, PR 00674
Mailing address
191 Calle Zumbador
Morovis, PR 00687
Phone (787) 390-4724
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11006883 | FL | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1104584358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 CALLE ZUMBADOR",
"city": "MOROVIS",
"state": "PR",
"postal_code": "00687",
"telephone_number": "787-390-4724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE HERNANDEZ CARRION",
"city": "MANATI",
"state": "PR",
"postal_code": "00674",
"telephone_number": "787-621-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "DERECK",
"middle_name": "NORBERTO",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-06",
"last_updated": "2021-12-06",
"certification_date": "2021-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "11006883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.