Individual provider Active NPI

Jessica Gutierrez Santiago, M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1124214218
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME112748 Issued in FL
Practice address
1601 Park Center Dr Ste 6B
Orlando, FL 32835-5700
Phone
(407) 249-1234
Fax
(407) 249-1755
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 11742 I PR
Pediatrics Physician 208000000X 17851 PR
Pediatrics Physician 208000000X ME112748 FL Primary

Addresses

Primary practice location

1601 Park Center Dr Ste 6B
Orlando, FL 32835-5700

Mailing address

1651 N Semoran Blvd
Orlando, FL 32807-3575
Phone (407) 249-1234

Other identifiers 1

IdentifierTypeStateIssuer
009358300MedicaidFL

Other names 1

  • Dr. Jessica Gutierrez Santiago Professional name

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME112748FLMDPediatrics Physician
11742 IPRMDPediatrics Physician
17851PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics PastSince Mar 27, 2022 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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1124214218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073575",
            "telephone_number": "407-249-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 PARK CENTER DR STE 6B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355700",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ SANTIAGO",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "11742 I",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "17851",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME112748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009358300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GUTIERREZ SANTIAGO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; 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.