Individual provider Active NPI

Stanley Rivera Santiago, MD

  • Obstetrics & Gynecology Physician
  • Key West, FL
National Provider Identifier
1316924285
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME113009 Issued in FL
Practice address
1111 12TH St
Suite 104
Key West, FL 33040-4088
Phone
(305) 293-1830
Fax
(305) 293-2937
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME113009 FL Primary

Addresses

Primary practice location

1111 12TH St
Suite 104
Key West, FL 33040-4088

Mailing address

1111 12TH St
Suite 104
Key West, FL 33040-4088

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stanley.santiago.1@4692.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140723002092 FL Practitioner - Obstetrics/Gynecology 8224077268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key West Hma Physician Management LLCGroup PAC ID 0749178408, 33 clinicians

Practice addresses (Care Compare)

1111 12TH St
Suite 104
Key West, FL 33040-4084
Phone (305) 293-1830

Hospital & facility affiliations

  • Lower Keys Medical Center Hospital, Key West, FL, CCN 100150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of South Florida, Inc CurrentSince Feb 26, 2017 Accepting new patients
Key West Hma Physician Management, LLC Obstetrics & Gynecology CurrentSince May 19, 2014 Accepting new patients
Key West Hma Physician Management LLC CurrentSince May 19, 2014 Accepting new patients
Community Health of South Florida Inc CurrentSince Feb 26, 2017 Accepting new patients
Temple Physician Inc. Past Accepting new patients

Locations

10300 SW 216th St
Cutler Bay, FL 33190

1111 12th St
Ste 104
Key West, FL 33040
Phone (305) 293-1830

2805 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-4000

Interoperability endpoints

  • Direct secure messaging: stanley.santiago.1@4692.direct.athenahealth.com

Organizations & group practices 5

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.

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1316924285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 12TH ST",
            "address_2": "SUITE 104",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 12TH ST",
            "address_2": "SUITE 104",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404088",
            "telephone_number": "305-293-1830",
            "fax_number": "305-293-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "STANLEY",
        "middle_name": "RIVERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME113009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stanley.santiago.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1111 12th St",
            "address_2": "SUITE 104",
            "city": "Key West",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330404088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.