Individual provider Active NPI

Marcia Santiago, CDN, IBCLC, CD(DONA)

  • Registered Dietitian
  • Staten Island, NY
National Provider Identifier
1144789561
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
010734 Issued in NY
Practice address
937 Victory Blvd Apt 4E
Staten Island, NY 10301-3734
Phone
(347) 744-0766
NPI assigned
Mar 15, 2019
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X
Lactation Consultant (Non-RN)Group: 193200000X MULTI-SPECIALTY GROUP 174N00000X
DoulaGroup: 193200000X MULTI-SPECIALTY GROUP 374J00000X
Registered Dietitian 133V00000X 010734 NY Primary

Addresses

Primary practice location

937 Victory Blvd Apt 4E
Staten Island, NY 10301-3734

Mailing address

937 Victory Blvd Apt 4E
Staten Island, NY 10301-3734
Phone (347) 744-0766

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group of New Jersey, P.C. Multi-Specialty Past Accepting new patients
Cloud Health Medical Group of California, P.C. Multi-Specialty Past Accepting new patients
Cloud Health Medical Group, P.a. Multi-Specialty Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1144789561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 VICTORY BLVD APT 4E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013734",
            "telephone_number": "347-744-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 VICTORY BLVD APT 4E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013734",
            "telephone_number": "347-744-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MARCIA",
        "credential": "CDN, IBCLC, CD(DONA)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "010734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.