Individual provider Active NPI

Ismael Flores-Santiago, MD

  • Internal Medicine Physician
  • Raleigh, NC
National Provider Identifier
1124056072
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2013-00354 Issued in NC
Practice address
1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone
(919) 833-3111
Fax
(919) 834-3118
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28580 AZ
Internal Medicine Physician 207R00000X 2013-00354 NC Primary

Addresses

Primary practice location

1001 Rock Quarry Rd
Raleigh, NC 27610-3825

Mailing address

911 Reunion Park Dr
Apex, NC 27539-6870
Phone (321) 986-7417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200908001440 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2668668195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28580AZMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1124056072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 REUNION PARK DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275396870",
            "telephone_number": "321-986-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-833-3111",
            "fax_number": "919-834-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES-SANTIAGO",
        "first_name": "ISMAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "28580",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-00354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.