Pamela G Santelices, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME80098 Issued in FL

Practice address

1859 SW Newland Way
Lake City, FL 32025-6966

Phone

(386) 758-0003

Fax

(386) 755-7940

NPI assigned

Mar 24, 2006

Last updated

Dec 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Pamela Montesino Gellecanao Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pamela.santelices.p1@direct.nfpeds.nextgenshare.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Acute Care Pediatrics of Palm Coast, PA

  • Rural Health Clinic/Center
  • Palm Coast, FL
  • NPI 1225065717

  Operational/Managerial Control

  CMS ownership
• Acute Care Pediatrics,PA

  • Rural Health Clinic/Center
  • Palatka, FL
  • NPI 1003866732

  Operational/Managerial Control

  CMS ownership

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.

• North Florida Pediatrics, PA

  • Rural Health Clinic/Center
  • Live Oak, FL
  • NPI 1558602482

  Pediatrics

  Medicare reassignment NPD
• Acute Care Pediatrics,PA

  • Rural Health Clinic/Center
  • Palatka, FL
  • NPI 1003866732

  Pediatrics

  NPD
• North Florida Pediatrics PA

  • Rural Health Clinic/Center
  • Starke, FL
  • NPI 1548758428

  Pediatrics

  NPD
• Acute Care Pediatrics of Palm Coast, PA

  • Rural Health Clinic/Center
  • Palm Coast, FL
  • NPI 1225065717

  Pediatrics

  NPD (past)
• North Florida Pediatrics, PA

  • Rural Health Clinic/Center
  • Jasper, FL
  • NPI 1033114285

  Pediatrics

  NPD (past)
• North Florida Pediatrics, PA.

  • Rural Health Clinic/Center
  • Lake City, FL
  • NPI 1376548602

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1609836683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256966",
            "telephone_number": "386-758-0003",
            "fax_number": "386-755-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256966",
            "telephone_number": "386-758-0003",
            "fax_number": "386-755-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTELICES",
        "first_name": "PAMELA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME80098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58641",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "275981",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259783700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "GELLECANAO",
            "middle_name": "MONTESINO",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Sue Sanders, MPT
• William David Sanders, PA
• Taylor J Sansone, DPT
• Robert J Sansouci III III
• Marisol Isabel Santamarina, ARNP
• Samuel Santelices, MD
• Benjamin Malabanan Santos, DPM
• Katie Sapir, AUD
• Ashley Sapp-Edwards
• Lanitra P Sapp

• Pediatrics Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.