Individual provider Active NPI

Patrick C Santos, MD

  • Family Medicine Physician
  • Upper Tumon, GU
National Provider Identifier
1609937762
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M001195 Issued in GU
Practice address
125 Carlos Lane
Carlos Heights
Upper Tumon, GU 96913
Phone
(671) 649-5052
Fax
(671) 649-5054
NPI assigned
Dec 13, 2006
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M001195 GU Primary

Addresses

Primary practice location

125 Carlos Lane
Carlos Heights
Upper Tumon, GU 96913

Mailing address

125 Carlos LN
Tamuning, GU 96913-4339
Phone (671) 649-5052

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040426000315 HI Practitioner - Family Practice 3274422936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Carlos LN
Tamuning, GU 96913-4339
Phone (671) 649-5052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M001195GUMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tumon Medical Office Family Medicine CurrentSince Apr 22, 2003 Accepting new patients

Locations

125 Carlos Ln
Tamuning, GU 96913
Phone (671) 649-5052

125 Carlos Ln
Uppr
Tamuning, GU 96913
Phone (671) 649-5052

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1609937762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CARLOS LN",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134339",
            "telephone_number": "671-649-5052",
            "fax_number": "671-649-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CARLOS LANE",
            "address_2": "CARLOS HEIGHTS",
            "city": "UPPER TUMON",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-649-5052",
            "fax_number": "671-649-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "PATRICK",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "M001195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Tumon, GU

Sources for this page

Verify at the official NPI Registry.