Paulus L. Santoso, M.D.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

A85478 Issued in CA

Practice address

6969 Brockton Ave
Ste. a-B
Riverside, CA 92506-3809

Phone

(951) 530-8989

Fax

(951) 530-8877

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Obstetrics/Gynecology

Education

State University of New York Downstate Medical Center, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Paulus Santoso MD a Professional Corporation

  • Obstetrics Physician
  • Riverside, CA
  • NPI 1093042970
  Medicare reassignment NPD Authorized official
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Doctors Hospital of Riverside LLC

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1124596382
  NPD (past)
• Riverside Healthcare System, L.P.

  • Rehabilitation Hospital Unit
  • Riverside, CA
  • NPI 1053358010
  NPD (past)
• Uhs Corona Inc

  • Rehabilitation Hospital Unit
  • Corona, CA
  • NPI 1255327920
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1154329373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6969 BROCKTON AVE",
            "address_2": "STE. A-B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063809",
            "telephone_number": "951-530-8989",
            "fax_number": "951-530-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6969 BROCKTON AVE",
            "address_2": "STE. A-B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063809",
            "telephone_number": "951-530-8989",
            "fax_number": "951-530-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOSO",
        "first_name": "PAULUS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A85478",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "A85478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A854780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanalyn M.M. Santos
• Julio Santos
• Lauren-Marife Santos
• Mia Juliana Santos
• Wendy Y Santos
• Geovanni Santoyo
• Alpha Iscandari Sanusi, BOCPO
• Sayra Sapien
• Yasmin Saqqa
• Cindy Ivette Sarabia

• Obstetrics Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Obstetrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.