Individual provider Active NPI

Richard Santostefano Sr.

  • Physician Assistant
  • Huntington, WV
National Provider Identifier
1275781387
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13 Issued in WV
Practice address
1448 10TH Ave Ste 100
Huntington, WV 25701-3580
Phone
(304) 529-0753
Fax
(304) 529-0591
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 723 WV
Physician Assistant 363A00000X 13 WV Primary

Addresses

Primary practice location

1448 10TH Ave Ste 100
Huntington, WV 25701-3580

Mailing address

1448 10TH Ave Ste 100
Huntington, WV 25701-3580
Phone (304) 529-0753

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address richard.santostefano@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20170620000440 WV Practitioner - Physician Assistant 1153699905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1448 10TH Ave
Suite 100
Huntington, WV 25701-3580
Phone (304) 529-0753

1600 Medical Ctr Dr
Huntington, WV 25701-3655

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince May 1, 2017 Accepting new patients

Locations

1448 10th Ave
Ste 100
Huntington, WV 25701
Phone (304) 529-0753

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1249 15th St
Ste 4093
Huntington, WV 25701
Phone (304) 691-8714

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1275781387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 100",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013580",
            "telephone_number": "304-529-0753",
            "fax_number": "304-529-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 100",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013580",
            "telephone_number": "304-529-0753",
            "fax_number": "304-529-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOSTEFANO",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "723",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.santostefano@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1448 10th Ave Ste 100",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.