Individual provider Active NPI

Maria L Collazo-Santiago, PHYSICAL THERAPIST

  • Physical Therapist
  • Humacao, PR
National Provider Identifier
1376176701
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
879 Issued in PR
Practice address
55 Calle Flor Gerena S
Humacao, PR 00791-4207
Phone
(787) 285-0080
Fax
(787) 285-0461
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 879 PR Primary

Addresses

Primary practice location

55 Calle Flor Gerena S
Humacao, PR 00791-4207

Mailing address

21 Calle Cerezo
Las Piedras, PR 00771-9023
Phone (939) 216-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504001410 PR Practitioner - Physical Therapist in Private Practice 7911338165 Practice locations: Dorado, PR; Humacao, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
879PRMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dba Dr. Noel Arnau CurrentSince Feb 24, 2022 Accepting new patients

Locations

55 Calle Flor Gerena S
Humacao, PR 00791
Phone (787) 285-0080

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1376176701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CALLE CEREZO",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719023",
            "telephone_number": "939-216-1924",
            "fax_number": "787-285-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE FLOR GERENA S",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914207",
            "telephone_number": "787-285-0080",
            "fax_number": "787-285-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO-SANTIAGO",
        "first_name": "MARIA",
        "middle_name": "L",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.