Individual provider Active NPI

Jorge Luis Santander, MD

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1467499285
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME83255 Issued in FL
Practice address
4080 SW 84TH Ave
Ste D
Miami, FL 33155-4201
Phone
(305) 223-1140
Fax
(305) 223-1174
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME83255 FL Primary

Addresses

Primary practice location

4080 SW 84TH Ave
Ste D
Miami, FL 33155-4201

Mailing address

4080 SW 84TH Ave
Ste D
Miami, FL 33155-4201
Phone (305) 223-1140

Other identifiers 1

IdentifierTypeStateIssuer
262741800MedicaidFL

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
I20031105000534 FL Practitioner - General Practice 7012829229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4080 SW 84 Ave
Suite D
Miami, FL 33155-4201
Phone (305) 223-1140

Hospital & facility affiliations

  • Professional Plus Home Health Inc Home health agency, Miami, FL, CCN 109703

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Med-Union Medical Center Inc Past Accepting new patients
Falls Medical Care, Inc. Past Accepting new patients
Cicero Ortho-Med Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jorge.santander@direct.meditouchehr.com

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.

Hospital & facility affiliations 1

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1467499285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 SW 84TH AVE",
            "address_2": "STE D",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554201",
            "telephone_number": "305-223-1140",
            "fax_number": "305-223-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 SW 84TH AVE",
            "address_2": "STE D",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554201",
            "telephone_number": "305-223-1140",
            "fax_number": "305-223-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANDER",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME83255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262741800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.