Individual provider Active NPI

Santiago Javier Aguilar Duenas, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1285897553
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47231 Issued in TN
Practice address
6019 Walnut Grove Rd
Memphis, TN 38120
Phone
(901) 226-3610
Fax
(901) 226-3612
NPI assigned
Jul 8, 2008
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-12764 AR
Internal Medicine Physician 207R00000X 23275 MS
Internal Medicine Physician 207R00000X 47231 TN Primary

Addresses

Primary practice location

6019 Walnut Grove Rd
Memphis, TN 38120

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Other practice location 1

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2980

Other practice location 2

2100 N 7th St
West Memphis, AR 72301-2017
Phone (901) 226-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, AR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20111011000282 TN Practitioner - Internal Medicine 8527230846 Reassigns benefits to 2 organizations
I20140925000705 MS Practitioner - Internal Medicine 8527230846 Reassigns benefits to 2 organizations
I20200824003146 AR Practitioner - Internal Medicine 8527230846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Greenbrook Physician Services, LLCGroup PAC ID 5597267427, 70 clinicians

Practice addresses (Care Compare)

2013 Exeter Rd
Germantown, TN 38138-3946
Phone (901) 737-4035

216 Oxford Rd
New Albany, MS 38652-3115
Phone (662) 534-9042

255 Baptist Blvd
Columbus, MS 39705-2006

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-12764ARMDInternal Medicine Physician
23275MSMDInternal Medicine Physician
47231TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Nov 18, 2023 Accepting new patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Aug 11, 2014 Accepting new patients
Greenbrook Physician Services, LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Aug 11, 2014 Accepting new patients

Locations

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

2100 Exeter Rd
Memphis, TN 38138
Phone (901) 757-1350

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

6025 Walnut Grove Rd
Ste 400
Memphis, TN 38120
Phone (901) 226-1309

6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727

7205 Wolf River Blvd
Ste 100
Memphis, TN 38138
Phone (901) 507-9466

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1285897553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Southcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714739",
            "country_code": "US",
            "telephone_number": "662-772-2980",
            "fax_number": "662-772-2960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 N 7th St",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723012017",
            "country_code": "US",
            "telephone_number": "901-226-3610",
            "fax_number": "901-226-3612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUILAR DUENAS",
        "first_name": "SANTIAGO",
        "middle_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-12764",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "47231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.