Individual provider Active NPI

Julian Santiago-Marrero, MD

  • General Practice Physician
  • Manati, PR
National Provider Identifier
1134859283
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23577 Issued in PR
Practice address
Urb Atenas Calle Hernandez Carrion
Carr #2 Int 668
Manati, PR 00674
Phone
(787) 988-0721
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23577 PR Primary
Physician Assistant 363A00000X 210 PR

Addresses

Primary practice location

Urb Atenas Calle Hernandez Carrion
Carr #2 Int 668
Manati, PR 00674

Mailing address

HC 4 Box 57870
Morovis, PR 00687-7600
Phone (787) 988-0721

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
I20241003003822 PR Practitioner - General Practice 8921539735 Practice locations: Ciales, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210PRMDOptometrist
23577PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prymed Medical Care Inc Past Accepting new patients

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1134859283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 57870",
            "city": "MOROVIS",
            "state": "PR",
            "postal_code": "006877600",
            "telephone_number": "787-988-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB ATENAS CALLE HERNANDEZ CARRION",
            "address_2": "CARR #2 INT 668",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "00674",
            "telephone_number": "787-988-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-MARRERO",
        "first_name": "JULIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23577",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

Verify at the official NPI Registry.