Individual provider Active NPI

Manuel Santiago

  • Registered Nurse
  • Pasadena, MD
National Provider Identifier
1609521723
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R185817 Issued in MD
Practice address
414 Quiet Woods CT
Pasadena, MD 21122-7517
Phone
(443) 942-3402
NPI assigned
Feb 16, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R185817 MD Primary

Addresses

Primary practice location

414 Quiet Woods CT
Pasadena, MD 21122-7517

Mailing address

414 Quiet Woods CT
Pasadena, MD 21122-7517
Phone (443) 942-3402

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pasadena Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R185817MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1609521723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 QUIET WOODS CT",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227517",
            "telephone_number": "443-942-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 QUIET WOODS CT",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227517",
            "telephone_number": "443-942-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R185817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pasadena",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Pasadena",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pasadena",
            "address_1": "414 Quiet Woods Ct",
            "city": "Pasadena",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211227517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.