Individual provider Active NPI

Jesus Santiago, PA

  • Surgical Physician Assistant
  • Greenwich, CT
National Provider Identifier
1215044672
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
25 Valley Dr
Greenwich, CT 06831-5203
Phone
(203) 661-3333
Fax
(203) 661-5610
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

25 Valley Dr
Greenwich, CT 06831-5203

Mailing address

25 Valley Dr
Greenwich, CT 06831-5203
Phone (203) 661-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111228000153 CT Practitioner - Physician Assistant 7618143470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

2800 Main St
Bridgeport, CT 06606-4201

300 Post Rd W
FL 1
Westport, CT 06880-4703
Phone (203) 332-3272

Hospital & facility affiliations

  • St Vincent'S Medical Center Hospital, Bridgeport, CT, CCN 070028
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000447CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Aug 1, 2013 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Mar 30, 2020 Accepting new patients
Yale University CurrentSince Aug 1, 2013 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Mar 30, 2020 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC Past Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: jesus.santiago@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1215044672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 VALLEY DR",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315203",
            "telephone_number": "203-661-3333",
            "fax_number": "203-661-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 VALLEY DR",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315203",
            "telephone_number": "203-661-3333",
            "fax_number": "203-661-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JESUS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.