Individual provider Active NPI

Amy D Santiago, APN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1578940490
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN001935 Issued in NV
Practice address
4432 S Eastern Ave
Las Vegas, NV 89119-7825
Phone
(702) 733-2982
Fax
(702) 733-3824
NPI assigned
Apr 29, 2015
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN001935 NV Primary

Addresses

Primary practice location

4432 S Eastern Ave
Las Vegas, NV 89119-7825

Mailing address

700 Shadow LN
Ste 240
Las Vegas, NV 89106-4158
Phone (702) 733-2982

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160322001428 NV Practitioner - Nurse Practitioner 6204133093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN001935NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Center of Nevada CurrentSince Aug 16, 2021 Accepting new patients

Locations

3196 S Maryland Pkwy
Ste 207
Las Vegas, NV 89109
Phone (702) 369-3400

5380 S Rainbow Blvd
Ste 226
Las Vegas, NV 89118
Phone (702) 260-0022

653 N Town Center Dr
Ste 410
Las Vegas, NV 89144
Phone (702) 456-3120

6850 N Durango Dr
Ste 312
Las Vegas, NV 89149
Phone (702) 433-0022

700 Shadow Ln
Ste 240
Las Vegas, NV 89106
Phone (702) 384-0022

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72343

Organizations & group practices 1

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1578940490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHADOW LN",
            "address_2": "STE 240",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064158",
            "telephone_number": "702-733-2982",
            "fax_number": "702-733-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197825",
            "telephone_number": "702-733-2982",
            "fax_number": "702-733-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "AMY",
        "middle_name": "D",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN001935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.