Individual provider Active NPI

Eugene Santos

  • Family Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1386119725
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009668 Issued in CA
Practice address
1700 N Waterman Ave
San Bernardino, CA 92404-5115
Phone
(909) 883-8611
NPI assigned
Oct 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009668 CA Primary

Addresses

Primary practice location

1700 N Waterman Ave
San Bernardino, CA 92404-5115

Mailing address

3600 Lime St Ste 516
Riverside, CA 92501-0944
Phone (951) 367-1060

Other practice location 1

3600 Lime St Ste 516
Riverside, CA 92501-0944
Phone (951) 367-1060

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210629002603 CA Practitioner - Nurse Practitioner 7719388677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

1700 N Waterman Ave
San Bernardino, CA 92404-5115
Phone (909) 883-8611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayflower Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Shams Iqbal Inc PastSince Nov 17, 2019 Accepting new patients

Locations

140 N Orange Ave
Ste 100
West Covina, CA 91790
Phone (626) 800-1200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1386119725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIME ST STE 516",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925010944",
            "telephone_number": "951-367-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045115",
            "telephone_number": "909-883-8611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Lime St Ste 516",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925010944",
            "country_code": "US",
            "telephone_number": "951-367-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.