Individual provider Active NPI

Rafael Antonio Santiago-Gonzalez, MD

  • Interventional Pain Medicine Physician
  • Bay Pines, FL
National Provider Identifier
1366480543
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME96525 Issued in FL
Practice address
10000 Bay Pines Blvd
Bay Pines, FL 33744-8200
Phone
(727) 398-6661
Fax
(727) 398-9440
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME96525 FL
Interventional Pain Medicine Physician 208VP0014X ME96525 FL Primary

Addresses

Primary practice location

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200

Mailing address

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200
Phone (727) 398-6661

Other names 1

  • Rafael Santiago Other name

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
I20080207000279 FL Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 0042393597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.82 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radial Health Southeast LLC Physical Medicine & Rehabilitation CurrentSince Mar 1, 2021 Accepting new patients

Locations

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1366480543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661",
            "fax_number": "727-398-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661",
            "fax_number": "727-398-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-GONZALEZ",
        "first_name": "RAFAEL",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME96525",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME96525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFAEL",
            "last_name": "SANTIAGO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bay Pines, FL

Sources for this page

Verify at the official NPI Registry.