Individual provider Active NPI

Jorge Luis Santiago, OTR/L

  • Occupational Therapist
  • Spokane Valley, WA
National Provider Identifier
1114629318
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61396051 Issued in WA
Practice address
12410 E Sinto Ave Ste 101
Spokane Valley, WA 99216-2258
Phone
(509) 789-2956
Fax
(509) 789-2976
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT61396051 WA Primary

Addresses

Primary practice location

12410 E Sinto Ave Ste 101
Spokane Valley, WA 99216-2258

Mailing address

12410 E Sinto Ave Ste 101
Spokane Valley, WA 99216-2258
Phone (509) 789-2956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230421002169 ID Practitioner - Occupational Therapist in Private Practice 0547625758 Reassigns benefits to 1 organization
I20231212002990 WA Practitioner - Occupational Therapist in Private Practice 0547625758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Orthopaedic Specialists PSGroup PAC ID 7113811654, 83 clinicians

Practice addresses (Care Compare)

12410 E Sinto Ave
Suite 101
Spokane Valley, WA 99216-2258
Phone (509) 789-2955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Orthopaedic Specialists PS CurrentSince Jun 10, 2024 Accepting new patients
Orthopedic Surgery and Sports Hand CurrentSince Apr 1, 2023 Accepting new patients
T Daniel Dibble MD PC CurrentSince Nov 1, 2023 Accepting new patients
Orthopedic Surgery and Sports CurrentSince Apr 1, 2023 Accepting new patients
Northwest Orthopaedic Specialists, P.S. CurrentSince Jun 10, 2024 Accepting new patients
T Daniel Dibble MD PC CurrentSince Nov 1, 2023 Accepting new patients

Locations

850 W Ironwood Dr
Ste 202
Coeur D Alene, ID 83814
Phone (208) 601-6038

1812 N Lakewood Dr
Ste 100
Coeur D Alene, ID 83814
Phone (208) 770-2971

1160 E Polston Ave
#B
Post Falls, ID 83854
Phone (208) 262-0156

510 E Holland Ave
Spokane, WA 99218
Phone (509) 363-3100

601 W 5th Ave
Ste 400
Spokane, WA 99204
Phone (509) 344-2663

12410 E Sinto Ave
Ste 101
Spokane Valley, WA 99216
Phone (509) 789-2955

1123 N Evergreen Rd
Spokane Valley, WA 99216
Phone (509) 363-3100

Interoperability endpoints

  • Direct secure messaging: jorge.santiago.1@16598.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1114629318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 E SINTO AVE STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162258",
            "telephone_number": "509-789-2956",
            "fax_number": "509-789-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 E SINTO AVE STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162258",
            "telephone_number": "509-789-2956",
            "fax_number": "509-789-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61396051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.