Individual provider Active NPI

Heidi Michelle Santiago, PA-C

  • Surgical Physician Assistant
  • Westport, CT
National Provider Identifier
1326695792
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4630 Issued in CT
Practice address
300 Post Rd W
Westport, CT 06880-4703
Phone
(203) 332-3272
NPI assigned
Aug 21, 2019
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X 4630 CT
Surgical Physician Assistant 363AS0400X 4630 CT Primary

Addresses

Primary practice location

300 Post Rd W
Westport, CT 06880-4703

Mailing address

300 Post Rd W
Westport, CT 06880-4703
Phone (203) 332-3272

Other identifiers 1

IdentifierTypeStateIssuer
4630OtherCTSTATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH

Other names 1

  • Heidi Michelle Walberg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191126002788 CT Practitioner - Physician Assistant 2163855453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

2800 Main St
Bridgeport, CT 06606-4201

300 Post Rd W
FL 1
Westport, CT 06880-4703
Phone (203) 332-3272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4630CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Jul 1, 2020 Accepting new patients
Yale University CurrentSince Oct 13, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jul 1, 2020 Accepting new patients
Yale University CurrentSince Oct 13, 2019 Accepting new patients

Locations

1 Long Wharf Dr
Fl 6
New Haven, CT 06511
Phone (203) 688-1422

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: hwalberg242055@xdr.hhchealthdirect.org

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1326695792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804703",
            "telephone_number": "203-332-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804703",
            "telephone_number": "203-332-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "HEIDI",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4630",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "4630",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "WALBERG",
            "middle_name": "MICHELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.