Michelle Santiago-Medina, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P06330 Issued in NY

Practice address

1235 Pelham Pkwy N
Bronx, NY 10469-5817

Phone

(718) 231-4300

NPI assigned

Jul 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• Jamaica Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  Medicare reassignment NPD
• Jamaica Hospital

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1750516795
  NPD

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1477075232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 92ND ST",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171503",
            "telephone_number": "939-250-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PELHAM PKWY N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695817",
            "telephone_number": "718-231-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-MEDINA",
        "first_name": "MICHELLE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P06330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abeer Santarisi, MD
• Nicholas Spartan Santavicca, M.D.
• Leslie Anne Santelices, PT
• Carolina Santelises
• Sonu Santhosh
• Damaris Santiago-Singer, MHC
• Abelardo Joshua Santiago Jr.
• Adriana Santiago, MD
• Alma Santiago
• Aramis Ewon Santiago, MD

• Clinical Psychologist in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.