Active NPI
Diana Idalia Santos, MD
- General Practice Physician
- Aguadilla, PR
National Provider Identifier
1487647236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 6274
- Practice address
- Calle Progreso #8 Altos
Aguadilla, PR 00603-5008 - Phone
- (787) 819-0194
- Fax
- (787) 819-0194
- NPI assigned
- Aug 26, 2005
- Last updated
- Jan 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 6274 | PR | Primary |
Addresses
Primary practice location
Calle Progreso #8 Altos
Aguadilla, PR 00603-5008
Mailing address
Calle Progreso #14
PMB 55
Aguadilla, PR 00603-5008
Phone (787) 819-0194
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901 1 | Other | PR | PROSSAM |
| 16274 | Other | PR | MCS |
| 67065 | Other | PR | BLUE CROSS |
| 316274 | Other | PR | UIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101008000176 | PR | Practitioner - General Practice | 9133311186 | Practice locations: Aguadilla, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6274 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1487647236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CALLE PROGRESO #14",
"address_2": "PMB 55",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006035008",
"telephone_number": "787-819-0194",
"fax_number": "787-819-0194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE PROGRESO #8 ALTOS",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006035008",
"telephone_number": "787-819-0194",
"fax_number": "787-819-0194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "DIANA",
"middle_name": "IDALIA",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-26",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "6274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROSSAM",
"identifier": "2901 1",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCS",
"identifier": "16274",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "67065",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UIA",
"identifier": "316274",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.