Marlyn Aracely Paniagua, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

239466 Issued in WI

Practice address

2906 S 20TH St
Milwaukee, WI 53215-3732

Phone

(414) 672-1353

Fax

(414) 385-7551

NPI assigned

May 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marlyn Santiago Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1417912999
  Medicare reassignment NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1821517681
  NPD
• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Waukesha, WI
  • NPI 1144593815
  NPD (past)

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1558007393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 S 20TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153732",
            "telephone_number": "414-672-1353",
            "fax_number": "414-385-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANIAGUA",
        "first_name": "MARLYN",
        "middle_name": "ARACELY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "239466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLYN",
            "last_name": "SANTIAGO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vishal Bharat Pandya, MD
• Julie A Panepinto, MD
• Tze Pang, PHARM.D.
• Heidi M Pangborn, MD
• Angela Catherine Paniagua, PHARMD
• Jean Catherine Panich, PH.D.
• Jeanne Cole Panka, O.T.R.
• John Pankiewicz, M.D.
• Yashdip Pannu, MD
• Manish Krishna Pant, MD

• Family Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.

Verify at the official NPI Registry.