Individual provider Active NPI

Jo Ann Santiago, MD

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1114910346
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13133 Issued in PR
Practice address
San Rafael 1396
Suite #5 Medical Pavilion
San Juan, PR 00910
Phone
(787) 725-6713
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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 13133 PR Primary

Addresses

Primary practice location

San Rafael 1396
Suite #5 Medical Pavilion
San Juan, PR 00910

Mailing address

PO Box 8459
Fernandez Juncos Station
San Juan, PR 00910-0459
Phone (787) 725-6713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20040324000446 PR Practitioner - Internal Medicine 7012808322 Practice locations: San Juan, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13133FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Puerto Rico Health Care Group Internal Medicine Past Accepting new patients
Southern Health Care Group, Inc. Internal Medicine PastSince Oct 20, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1114910346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "address_2": "FERNANDEZ JUNCOS STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009100459",
            "telephone_number": "787-725-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN RAFAEL 1396",
            "address_2": "SUITE #5 MEDICAL PAVILION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00910",
            "telephone_number": "787-725-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JO ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "13133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.