Organization Active NPI

Ashley Santillo Nurse Practitioner in Adult Health PLLC

  • Adult Health Nurse Practitioner
  • Fairport, NY
National Provider Identifier
1114755600
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
ASHLEY SANTILLO NURSE PRACTITIONER IN ADULT HEALTH PLLC
Practice address
355 Hammocks Dr
Fairport, NY 14450-7006
Phone
(585) 520-2530
Fax
(585) 301-4003
NPI assigned
Jul 25, 2024
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Ashley Nicole Santillo, NP
Title
Owner
Phone
(585) 520-2530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU Primary

Addresses

Primary practice location

355 Hammocks Dr
Fairport, NY 14450-7006

Mailing address

355 Hammocks Dr
Fairport, NY 14450-7006
Phone (585) 520-2530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240819003012 NY Part B Supplier - Clinic/Group Practice 8123566379 Receives reassigned benefits from 1 practitioner
Practice locations: Fairport, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1114755600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 HAMMOCKS DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144507006",
            "telephone_number": "585-520-2530",
            "fax_number": "585-301-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 HAMMOCKS DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144507006",
            "telephone_number": "585-520-2530",
            "fax_number": "585-301-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY SANTILLO NURSE PRACTITIONER IN ADULT HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "SANTILLO",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-520-2530",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.