Individual provider Active NPI

David T Santellan, NP-C

  • Nurse Practitioner
  • Placerville, CA
National Provider Identifier
1245903558
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95017879 Issued in CA
Practice address
4341B Golden Center Dr
Placerville, CA 95667-6260
Phone
(530) 621-9600
Fax
(530) 748-0325
NPI assigned
Aug 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95017879 CA Primary

Addresses

Primary practice location

4341B Golden Center Dr
Placerville, CA 95667-6260

Mailing address

1910 23Rd St
Sacramento, CA 95816-7113
Phone (949) 973-4550

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922001855 CA Practitioner - Nurse Practitioner 9234536996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

4341 Golden Ctr Dr
Suite B
Placerville, CA 95667-6260
Phone (530) 621-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95017879CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Marshall Medical Center Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Marshall Medical Center Family Medicine Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

4341 Golden Center Dr
Bldg B
Placerville, CA 95667

4341 Golden Center Dr
Ste B
Placerville, CA 95667
Phone (530) 621-3600

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

Organizations & group practices 4

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 3

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": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1245903558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 23RD ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167113",
            "telephone_number": "949-973-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341B GOLDEN CENTER DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676260",
            "telephone_number": "530-621-9600",
            "fax_number": "530-748-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTELLAN",
        "first_name": "DAVID",
        "middle_name": "T",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-01",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.