Individual provider Active NPI

Xavier Santiago Guerra, PA-C

  • Physician Assistant
  • Maitland, FL
National Provider Identifier
1598466088
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2600 Westhall LN
Maitland, FL 32751-7102
Phone
(407) 303-0500
NPI assigned
Mar 13, 2023
Last updated
May 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 NU Primary

Addresses

Primary practice location

2600 Westhall LN
Maitland, FL 32751-7102

Mailing address

2600 Westhall LN Ste 300
Maitland, FL 32751-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230607002158 FL Practitioner - Physician Assistant 0941667877 Reassigns benefits to 1 organization

National Provider Directory

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

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": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1598466088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517102",
            "telephone_number": "407-303-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "XAVIER",
        "middle_name": "SANTIAGO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.