Individual provider Active NPI

Santiago Sanchez, PA-C

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1558037424
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5506 Issued in CT
Practice address
100 Reserve Rd Ste 4a
Danbury, CT 06810-5267
Phone
(203) 794-1979
NPI assigned
Aug 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5506 CT Primary

Addresses

Primary practice location

100 Reserve Rd Ste 4a
Danbury, CT 06810-5267

Mailing address

1752 Francis Lewis Blvd
Whitestone, NY 11357-3247

Other practice location 1

1752 Francis Lewis Blvd
Whitestone, NY 11357-3247
Phone (718) 746-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211105001347 NY Practitioner - Physician Assistant 8729477179 Reassigns benefits to 2 organizations
I20240209003778 CT Practitioner - Physician Assistant 8729477179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

100 Reserve Rd
Suite A4
Danbury, CT 06810-5267
Phone (203) 794-1979

115 Spencer St
Winsted, CT 06098-1140
Phone (860) 738-5814

2 Elizabeth St
Bethel, CT 06801-2100
Phone (203) 791-2221

950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 265-9600

Hospital & facility affiliations

  • Western Connecticut Home Care Inc Home health agency, Danbury, CT, CCN 077088
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5506CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medhat F Sami MD PC Internal Medicine Current Accepting new patients

Locations

1752 Francis Lewis Blvd
Whitestone, NY 11357
Phone (718) 746-9494

Organizations & group practices 4

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 3

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1558037424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 FRANCIS LEWIS BLVD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RESERVE RD STE 4A",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105267",
            "telephone_number": "203-794-1979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1752 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Whitestone",
            "state": "NY",
            "postal_code": "113573247",
            "country_code": "US",
            "telephone_number": "718-746-9494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.