Individual provider Active NPI

Cristine Marie Santiago Montalvo, M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1316399546
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME143677 Issued in FL
Practice address
840 Mercy Dr
Orlando, FL 32808-7820
Phone
(407) 905-8827
Fax
(407) 905-8998
NPI assigned
Jul 12, 2016
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21196 PR
Pediatrics Physician 208000000X ME143677 FL Primary

Addresses

Primary practice location

840 Mercy Dr
Orlando, FL 32808-7820

Mailing address

1668 W Peace St
Canton, MS 39046-5332
Phone (601) 859-5213

Other practice location 1

917 Ave Tito Castro
Ponce, PR 00716-4717
Phone (787) 407-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220809003726 MS Practitioner - Pediatric Medicine 6103208095 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME143677FLMDPediatrics Physician
21196PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
G a Carmichael Family Health Center, Inc CurrentSince Apr 13, 2022 Accepting new patients
G a Carmichael Family Health Center Inc Current Accepting new patients
G a Carmichael Family Health Center, Inc CurrentSince Apr 13, 2022 Accepting new patients

Locations

1668 W Peace St
Canton, MS 39046
Phone (601) 859-0050

1547 Jerry Clower Blvd
Yazoo City, MS 39194
Phone (662) 746-6531

Interoperability endpoints

  • Direct secure messaging: cristine.santiago.p1@direct.gacfhc.nextgenshare.com
  • Direct secure messaging: sjccristin@yourcarecommunity.org

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, 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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1316399546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-859-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 MERCY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087820",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "917 Ave Tito Castro",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007164717",
            "country_code": "US",
            "telephone_number": "787-407-6094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO MONTALVO",
        "first_name": "CRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "21196",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME143677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.