Angelo Jovito Caezar Santos Santiago

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95021619 Issued in CA

Practice address

17782 Cowan
Irvine, CA 92614-6030

Phone

(949) 722-7118

NPI assigned

Aug 19, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Progeny Psychiatric Clinic a Medical CorporationGroup PAC ID 4688904592, 33 clinicians

Jason Kellogg MD IncGroup PAC ID 9032266127, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• College Hospital Costa Mesa Hospital, Costa Mesa, CA, CCN 050543

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jason Kellogg M.D. Inc

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1235391624
  Medicare reassignment Care Compare group NPD
• Progeny Psychiatric Clinic a Medical Corporation

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1548735202
  Medicare reassignment Care Compare group
• Progeny TMS Corporation

  • Mental Health Counselor
  • Irvine, CA
  • NPI 1558062265
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CHCM, Inc.

  • General Acute Care Hospital
  • Costa Mesa, CA
  • NPI 1922039205
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1356069900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 CONCORD ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262807",
            "telephone_number": "714-823-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17782 COWAN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146030",
            "telephone_number": "949-722-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ANGELO",
        "middle_name": "JOVITO CAEZAR SANTOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Sangtongaroonkul, NP
• Vansida Sanklang, CERTI MASSAGE THERAP
• Karisma Ann Santalahti
• Matthew Santamaria, P.T.A.
• Noel M Santayana, PT, DPT
• Jazmin Santiago
• Alexis Teanna Santos
• Aminah Santos
• Elizabeth Santos
• Imelda Reyes Santos, OTR

• Psychiatric/Mental Health Nurse Practitioner in Irvine, CA
• Providers in Irvine, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.