Individual provider Active NPI

Jose Manuel Santiago Sr.

  • Social Worker
  • Malden, MA
National Provider Identifier
1245634179
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
730 Eastern Ave
Malden, MA 02148-5924
Phone
(781) 395-0457
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

730 Eastern Ave
Malden, MA 02148-5924

Mailing address

95 South St Apt 3
Lynn, MA 01905-2841

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

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1245634179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SOUTH ST APT 3",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019052841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 EASTERN AVE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485924",
            "telephone_number": "781-395-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JOSE MANUEL",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.