Individual provider Active NPI

Jessica Alicea-Santiago, FNP

  • Family Nurse Practitioner
  • Indian Island, ME
National Provider Identifier
1306516836
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP211282 Issued in ME
Practice address
23 Wabanaki Way
Indian Island, ME 04468-1252
Phone
(207) 817-7400
Fax
(207) 817-7459
NPI assigned
Sep 16, 2021
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP211282 ME Primary

Addresses

Primary practice location

23 Wabanaki Way
Indian Island, ME 04468-1252

Mailing address

23 Wabanaki Way
Indian Island, ME 04468-1252
Phone (207) 817-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230220001461 ME Practitioner - Nurse Practitioner 6608248604
I20260625003506 TX Practitioner - Nurse Practitioner 6608248604 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
Penobscot Indian Nation Finance OfficeGroup PAC ID 1850324542, 9 clinicians

Practice addresses (Care Compare)

23 Wabanaki Way
Indian Island, ME 04468-1252
Phone (207) 817-7400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
74.88
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP211282MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Respiratory CurrentSince Sep 23, 2021 Accepting new patients
Eastern Maine Medical Center CurrentSince Mar 12, 2023 Accepting new patients
Eastern Maine Medical Center CurrentSince Mar 12, 2023 Accepting new patients

Locations

417 State St
Ste 400
Bangor, ME 04401
Phone (207) 942-6096

489 State St
Bangor, ME 04401
Phone (207) 973-8837

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 1

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1306516836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WABANAKI WAY",
            "city": "INDIAN ISLAND",
            "state": "ME",
            "postal_code": "044681252",
            "telephone_number": "207-817-7400",
            "fax_number": "207-817-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WABANAKI WAY",
            "city": "INDIAN ISLAND",
            "state": "ME",
            "postal_code": "044681252",
            "telephone_number": "207-817-7400",
            "fax_number": "207-817-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA-SANTIAGO",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP211282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Island, ME

Sources for this page

Verify at the official NPI Registry.