Individual provider Active NPI

Chito Alfonso Santiago Colorado, ARNP

  • Acute Care Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1497464622
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP61411287 Issued in WA
Practice address
1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305
Phone
(253) 627-1244
Fax
(253) 627-6576
NPI assigned
Nov 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11023051 FL
Gerontology Nurse Practitioner 363LG0600X AP61411287 WA
Acute Care Nurse Practitioner 363LA2100X AP61411287 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305

Mailing address

1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305
Phone (253) 627-1244

Other identifiers 1

IdentifierTypeStateIssuer
2250959MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccolorado796693@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817000730 WA Practitioner - Nurse Practitioner 8022470434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1802 Yakima Ave
Suite 304
Tacoma, WA 98405-5305
Phone (253) 627-1244

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11023051FLMDAcute Care Nurse Practitioner
AP61411287WAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Jul 17, 2023 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1802 Yakima Ave
Ste 307
Tacoma, WA 98405
Phone (206) 627-1244

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1802 Yakima Ave
Ste 302
Tacoma, WA 98405
Phone (253) 591-6739

11311 Bridgeport Way SW
Ste 304
Tacoma, WA 98499
Phone (253) 983-1377

1802 Yakima Ave
Ste 304
Tacoma, WA 98405
Phone (253) 572-7101

Interoperability endpoints

  • Direct secure messaging: ccolorado796693@fhsce.catholichealth.net

Organizations & group practices 3

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 7

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": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1497464622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLORADO",
        "first_name": "CHITO ALFONSO",
        "middle_name": "SANTIAGO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-16",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11023051",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61411287",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61411287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2250959",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccolorado796693@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 304",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.