Active NPI
Andres G Santiviago, MD
- Obstetrics & Gynecology Physician
- Warren, MI
National Provider Identifier
1457342149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 4301035546
- Practice address
- 11012 E 13 Mile Rd
Ste 212
Warren, MI 48093-2572 - Phone
- (586) 582-7150
- Fax
- (586) 582-7164
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4301035546 | MI | Primary |
Addresses
Primary practice location
11012 E 13 Mile Rd
Ste 212
Warren, MI 48093-2572
Mailing address
11012 E 13 Mile Rd
Ste 212
Warren, MI 48093-2572
Phone (586) 582-7150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 407185110 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301035546 | MI | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261008000000",
"number": "1457342149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11012 E 13 MILE RD",
"address_2": "STE 212",
"city": "WARREN",
"state": "MI",
"postal_code": "480932572",
"telephone_number": "586-582-7150",
"fax_number": "586-582-7164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11012 E 13 MILE RD",
"address_2": "STE 212",
"city": "WARREN",
"state": "MI",
"postal_code": "480932572",
"telephone_number": "586-582-7150",
"fax_number": "586-582-7164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIVIAGO",
"first_name": "ANDRES",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2009-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "4301035546",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "407185110",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.