Individual provider Active NPI

Pacifico C. Santos, M.D.

  • Adult Medicine Physician
  • San Jose, CA
National Provider Identifier
1265547608
Registry record updated Oct 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A29516 Issued in CA
Practice address
200 N Jackson Ave
Suite D
San Jose, CA 95116-1601
Phone
(408) 251-4240
Fax
(408) 251-7859
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A29516 CA
Adult Medicine Physician 207QA0505X A29516 CA Primary

Addresses

Primary practice location

200 N Jackson Ave
Suite D
San Jose, CA 95116-1601

Mailing address

200 N Jackson Ave
Suite D
San Jose, CA 95116-1601
Phone (408) 251-4240

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A29516CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Cardiovascular Care a Medical Corporation Family Medicine CurrentSince Apr 1, 2011 Accepting new patients
County of Santa Clara Past Accepting new patients
Pacifico C. Santos, MD Inc Adult Medicine PastSince Sep 10, 1975 Accepting new patients

Locations

178 2nd St
Ste D
Gilroy, CA 95020
Phone (408) 842-5190

200 Jose Figueres Ave
San Jose, CA 95116
Phone (408) 259-3232

200 Jose Figueres Ave
Ste 325
San Jose, CA 95116
Phone (408) 937-9000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191715200000",
    "number": "1265547608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N JACKSON AVE",
            "address_2": "SUITE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161601",
            "telephone_number": "408-251-4240",
            "fax_number": "408-251-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N JACKSON AVE",
            "address_2": "SUITE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161601",
            "telephone_number": "408-251-4240",
            "fax_number": "408-251-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "PACIFICO",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A29516",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A29516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2007; 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.