NPIMap

Individual provider Active NPI

Richard Santos, MD

  • Internal Medicine Physician
  • Jackson, MI
National Provider Identifier
1104849025
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301112253 Issued in MI
Practice address
100 E Michigan Ave Ste 102
Jackson, MI 49201-1406
Phone
(517) 205-1731
Fax
(314) 362-9878
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301112253 MI Primary

Addresses

Primary practice location

100 E Michigan Ave Ste 102
Jackson, MI 49201-1406

Mailing address

100 E Michigan Ave Ste 102
Jackson, MI 49201-1406
Phone (517) 205-1731

Other identifiers 1

IdentifierTypeStateIssuer
207353400MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170622000958 MI Practitioner - Internal Medicine 8325071723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

100 E Michigan Ave
Jackson, MI 49201-1406

130 N Sherman St
Leslie, MI 49251-9409

205 N E Ave
Jackson, MI 49201-1753

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Aug 1, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

100 E Michigan Ave
Ste 102
Jackson, MI 49201
Phone (517) 205-1731

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: rsantos487948@direct.hfhs.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1104849025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011406",
            "telephone_number": "517-205-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011406",
            "telephone_number": "517-205-1731",
            "fax_number": "314-362-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301112253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207353400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.