Individual provider Active NPI

Angelito G Santos, MD

  • Emergency Medicine Physician
  • Tamuning, GU
National Provider Identifier
1447280680
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-1605 Issued in GU
Practice address
548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone
(671) 646-5825
Fax
(671) 646-0556
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20100122000242 GU Practitioner - Emergency MedicinePractitioner - Thoracic SurgeryPractitioner - Pediatric MedicinePractitioner - Vascular Surgery 2264458629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40092AZMDEmergency Medicine Physician
C53333CAMDEmergency Medicine Physician
M-1605GUMDEmergency Medicine Physician
37917IAMDEmergency Medicine Physician
ME0065167FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince May 4, 2010 Accepting new patients
Guam Memorial Hospital CurrentSince May 4, 2010 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Past Accepting new patients
Magnolia Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37917 IA
Emergency Medicine Physician 207P00000X C53333 CA
Emergency Medicine Physician 207P00000X M-1605 GU Primary
Emergency Medicine Physician 207P00000X 40092 AZ
Pediatrics Physician 208000000X ME0065167 FL

Addresses

NPPES NPI Registry

Primary practice location

548 S Marine Corps Dr
Tamuning, GU 96913-3539

Mailing address

821 Renmar Drive
Plantation, FL 33317-4219
Phone (954) 306-8411

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
32882OtherFLBCBS
252078800MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 4, 2009.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1447280680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 RENMAR DRIVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333174219",
            "telephone_number": "954-306-8411",
            "fax_number": "954-306-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 S MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133539",
            "telephone_number": "671-646-5825",
            "fax_number": "671-646-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ANGELITO",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "37917",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C53333",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "M-1605",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "40092",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0065167",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32882",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252078800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.