Active NPI
Ricardo Santiago
- Family Nurse Practitioner
- Crown Point, IN
National Provider Identifier
1356080386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71012635A
- Practice address
- 2293 N Main St
Crown Point, IN 46307-1854 - Phone
- (219) 755-3385
- Fax
- (219) 755-3387
- NPI assigned
- May 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71012635A | IN | Primary |
Addresses
Primary practice location
2293 N Main St
Crown Point, IN 46307-1854
Mailing address
8893 Clark PL
Crown Point, IN 46307-1651
Phone (787) 359-2855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71012635A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake County Jail | 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.
-
- Public Health or Welfare Agency
- Crown Point, IN
- NPI 1043626443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1356080386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8893 CLARK PL",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463071651",
"telephone_number": "787-359-2855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2293 N MAIN ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463071854",
"telephone_number": "219-755-3385",
"fax_number": "219-755-3387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "RICARDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-27",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71012635A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.