Individual provider Active NPI

Gregorio S Santos, MD

  • Internal Medicine Physician
  • Kenneth City, FL
National Provider Identifier
1417060369
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0072417 Issued in FL
Practice address
6125 54TH Ave N
Suite B
Kenneth City, FL 33709-1807
Phone
(727) 521-9467
Fax
(727) 521-0416
NPI assigned
Aug 16, 2006
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0072417 FL Primary

Addresses

Primary practice location

6125 54TH Ave N
Suite B
Kenneth City, FL 33709-1807

Mailing address

6125 54TH Ave N
Suite B
Kenneth City, FL 33709-1807
Phone (727) 521-9467

Other identifiers 1

IdentifierTypeStateIssuer
252703100MedicaidFL

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
I20041013000437 FL Practitioner - Internal Medicine 9436119591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6125 54TH Ave N
Suite B
Kenneth City, FL 33709-1807

6125 54TH N Ave
Suite B
Kenneth City, FL 33709-1830
Phone (727) 521-9467

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0072417FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregorio S Santos MD PA CurrentSince Feb 21, 1998 Accepting new patients
Community Hospitalists of Pinella PastSince Feb 2, 2006 Accepting new patients
Elias Kanaan MD PA Internal Medicine PastSince Aug 20, 2001 Accepting new patients

Locations

6125 54th Ave N
Ste B
Kenneth City, FL 33709
Phone (727) 521-9467

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADDJAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FIHGAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FIHGAA/Endpoint/FIHGAA

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1417060369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 54TH AVE N",
            "address_2": "SUITE B",
            "city": "KENNETH CITY",
            "state": "FL",
            "postal_code": "337091807",
            "telephone_number": "727-521-9467",
            "fax_number": "727-521-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 54TH AVE N",
            "address_2": "SUITE B",
            "city": "KENNETH CITY",
            "state": "FL",
            "postal_code": "337091807",
            "telephone_number": "727-521-9467",
            "fax_number": "727-521-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "GREGORIO",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0072417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252703100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenneth City, FL

Sources for this page

Verify at the official NPI Registry.