Carlos Damian Santiago, PA-C, DMO

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9102280 Issued in FL

Practice address

1727 Margarets Walk Rd
Green Cove Springs, FL 32043-3760

Phone

(904) 505-4040

NPI assigned

Apr 11, 2006

Sex

Male

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 VI

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Care, PLLCGroup PAC ID 7214014257, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Primary Care, PLLC

  • Preferred Provider Organization
  • Christiansted, VI
  • NPI 1114116951
  Medicare reassignment Care Compare group
• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment NPD
• St Croix Gastroenterology Center LLC

  • Specialist
  • St Croix, VI
  • NPI 1992983902
  Medicare reassignment
• St. Croix Diagnostics, LLC

  • General Practice Physician
  • Christiansted, VI
  • NPI 1346672854
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497718290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 MARGARETS WALK RD",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320433760",
            "telephone_number": "904-505-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 MARGARETS WALK RD",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320433760",
            "telephone_number": "904-505-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CARLOS",
        "middle_name": "DAMIAN",
        "credential": "PA-C, DMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9102280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rural Health Care Incorporated
• Rural Health Care, Inc.
• Shelley A. Ryan, MPT
• Russell Howard Sachs, MD
• Tasha Lynn Sanfiel, PTA
• School Board of Clay County
• School Board of Clay County
• School Board of Clay County
• Randall Scott, D.O.
• Jana Renee Shaddix Diaz, PT

• Physician Assistant in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.