Individual provider Active NPI

Carlos Soriano Santiago III, MD

  • Interventional Pain Medicine Physician
  • Cumberland, MD
National Provider Identifier
1306891148
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
D0027107 Issued in MD
Practice address
940 Seton Dr
Suite a
Cumberland, MD 21502-1818
Phone
(301) 777-2543
Fax
(301) 777-2583
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X D0027107 MD Primary

Addresses

Primary practice location

940 Seton Dr
Suite a
Cumberland, MD 21502-1818

Mailing address

11350 McCormick Rd
Executive Plaza 1, Suite 501
Hunt Valley, MD 21031-1002
Phone (301) 777-2543

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000125 WV Practitioner - AnesthesiologyPractitioner - Pain Management 0547169880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0027107MDMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Carlos Santiago Interventional Pain Center Past Accepting new patients

Organizations & group practices 1

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1306891148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "EXECUTIVE PLAZA 1, SUITE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "301-777-2543",
            "fax_number": "301-777-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SETON DR",
            "address_2": "SUITE A",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021818",
            "telephone_number": "301-777-2543",
            "fax_number": "301-777-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CARLOS",
        "middle_name": "SORIANO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MD",
            "license": "D0027107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.