Individual provider Active NPI

Antonio Santoro, PA

  • Medical Physician Assistant
  • Bristol, CT
National Provider Identifier
1124051750
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000088 Issued in CT
Practice address
Bristol Hospital, Brewster Rd.
Bristol, CT 06011-0977
Phone
(860) 585-3528
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000088 CT Primary

Addresses

Primary practice location

Bristol Hospital, Brewster Rd.
Bristol, CT 06011-0977

Mailing address

244 Coppermill Rd
Wethersfield, CT 06109-4013
Phone (860) 563-0115

Other identifiers 1

IdentifierTypeStateIssuer
290000088CT01OtherANTHEM BC & BS

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000088CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medhelp PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17217/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124051750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 COPPERMILL RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094013",
            "telephone_number": "860-563-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRISTOL HOSPITAL, BREWSTER RD.",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060110977",
            "telephone_number": "860-585-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORO",
        "first_name": "ANTONIO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "290000088CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.