Individual provider Active NPI

Ramon A Santos, SOCIAL WORKER

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1508386814
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851113986 Issued in MI
Practice address
730 Cesar E Chavez Ave
Grand Rapids, MI 49503-4920
Phone
(616) 685-8400
Fax
(616) 685-1322
NPI assigned
Jun 27, 2017
Last updated
Apr 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 100115 NY
Social Worker 104100000X 6851113986 MI Primary

Addresses

Primary practice location

730 Cesar E Chavez Ave
Grand Rapids, MI 49503-4920

Mailing address

PO Box 776974
Chicago, IL 60677-6974
Phone (231) 672-2119

Other identifiers 1

IdentifierTypeStateIssuer
1508386814MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231220000613 NY Practitioner - Clinical Social Worker 1951751767 Reassigns benefits to 2 organizations
I20240223000839 MI Practitioner - Clinical Social Worker 1951751767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

80 State St
Albany, NY 12207-2541
Phone (800) 997-6196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851113986MIMDSocial Worker
100115NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Nov 12, 2023 Accepting new patients
Grow Healthcare Group PA CurrentSince Jan 23, 2024 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

80 State St
Albany, NY 12207
Phone (415) 742-8411

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

Interoperability endpoints

  • Direct secure messaging: ramon.santos.1@30520.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1508386814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776974",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776974",
            "telephone_number": "231-672-2119",
            "fax_number": "313-432-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 CESAR E CHAVEZ AVE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034920",
            "telephone_number": "616-685-8400",
            "fax_number": "616-685-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "RAMON",
        "middle_name": "A",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "100115",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851113986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508386814",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.