Individual provider Active NPI

Michael Santos

  • General Practice Registered Nurse
  • Bayonne, NJ
National Provider Identifier
1184499790
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
808639 Issued in NY
Practice address
67 Trask Ave FL 2
Bayonne, NJ 07002-5227
Phone
(201) 556-8742
NPI assigned
Nov 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 808639 NY
General Practice Registered Nurse 163WG0000X 808639 NY Primary

Addresses

Primary practice location

67 Trask Ave FL 2
Bayonne, NJ 07002-5227

Mailing address

67 Trask Ave FL 2
Bayonne, NJ 07002-5227
Phone (201) 556-8742

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

State licenses

LicenseStateTypeSpecialty
808639NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1700784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1184499790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 TRASK AVE FL 2",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025227",
            "telephone_number": "201-556-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 TRASK AVE FL 2",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025227",
            "telephone_number": "201-556-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "808639",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "808639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.