NPIMap

Organization Active NPI

Medicos, P.a.

  • Internal Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1548024540
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICOS, P.A.
Practice address
506 2ND Ave N
North Myrtle Beach, SC 29582-3012
Phone
(843) 796-7422
Fax
(877) 817-3832
NPI assigned
Feb 9, 2024
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Dr. Kenneth Santiago, MDNPI 1801878186
Title
President
Phone
(843) 796-7422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

506 2ND Ave N
North Myrtle Beach, SC 29582-3012

Mailing address

PO Box 70157
Myrtle Beach, SC 29572-0021
Phone (843) 504-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240528002961 SC Part B Supplier - Clinic/Group Practice 1759723323 Receives reassigned benefits from 11 practitioners
Practice locations: North Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

506 2nd Ave N
North Myrtle Beach, SC 29582
Phone (843) 516-2024

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1548024540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70157",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295720021",
            "telephone_number": "843-504-2121",
            "fax_number": "843-487-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 2ND AVE N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823012",
            "telephone_number": "843-796-7422",
            "fax_number": "877-817-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-796-7422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.