Individual provider Active NPI

Maria Concepcion Santiago, NP

  • Adult Health Nurse Practitioner
  • Rego Park, NY
National Provider Identifier
1588433155
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311514 Issued in NY
Practice address
9525 Queens Blvd
2ND Floor, Suite a
Rego Park, NY 11374-4510
Phone
(718) 975-5280
NPI assigned
Dec 25, 2023
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311514 NY Primary

Addresses

Primary practice location

9525 Queens Blvd
2ND Floor, Suite a
Rego Park, NY 11374-4510

Mailing address

4012 165TH St Apt 1
Flushing, NY 11358-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260310003955 NY Practitioner - Nurse Practitioner 4587147392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Medical Group at North Nassau, PCGroup PAC ID 7618154550, 36 clinicians

Practice addresses (Care Compare)

9525 Queens Blvd
Suite a
Rego Park, NY 11374-4511
Phone (718) 975-5280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij Medical Group at North Nassau, PC CurrentSince Feb 1, 2026 Accepting new patients

Locations

9525 Queens Blvd
Ste A
Rego Park, NY 11374
Phone (718) 925-6210

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": "1703462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1588433155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 165TH ST APT 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 QUEENS BLVD",
            "address_2": "2ND FLOOR, SUITE A",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744510",
            "telephone_number": "718-975-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MARIA",
        "middle_name": "CONCEPCION",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-25",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.