Robert Santiago, MD, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

35-05-7517 Issued in OH

Legal business name

ROBERT SANTIAGO, MD, INC.

Practice address

396 Portland Way N
Galion, OH 44833-1115

Phone

(419) 462-5543

Fax

(419) 462-2058

NPI assigned

Feb 19, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dianne Santiago

Title

Co-Owner

Phone

(614) 431-8869

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Robert Santiago, M.D.

  • General Practice Physician
  • Galion, OH
  • NPI 1720121213
  Medicare reassignment NPD

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1578731972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 GLEN VILLAGE CT",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659677",
            "telephone_number": "614-431-8869",
            "fax_number": "614-431-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 PORTLAND WAY N",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331115",
            "telephone_number": "419-462-5543",
            "fax_number": "419-462-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT SANTIAGO, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "614-431-8869",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "OH",
            "license": "35-05-7517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "35-05-7517",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSN",
            "identifier": "$$$$$$$$$",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0759362",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP. EMPL. RISK",
            "identifier": "107669",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL (TYPE 1) NPI",
            "identifier": "1720121213",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Galion, OH
• Providers in Galion, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.