Active NPI
Gabriel Emmanuel Santiago
- Massage Therapist
- Casa Grande, AZ
National Provider Identifier
1619799277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 30208
- Practice address
- 312 W 10TH St Ste 2
Casa Grande, AZ 85122-3940 - Phone
- (520) 222-7385
- Fax
- (866) 727-9116
- NPI assigned
- Oct 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 30208 | AZ | Primary |
Addresses
Primary practice location
312 W 10TH St Ste 2
Casa Grande, AZ 85122-3940
Mailing address
747 W Torino PL
Casa Grande, AZ 85122
Phone (520) 450-6743
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30208 | AZ | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Casa Grande Community Acupuncture LLC | Single Specialty | Current | Accepting new patients |
Locations
312 W 10th St
Ste 2
Casa Grande, AZ 85122
Phone (520) 222-7385
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1619799277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 W TORINO PL",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "85122",
"telephone_number": "520-450-6743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 W 10TH ST STE 2",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "851223940",
"telephone_number": "520-222-7385",
"fax_number": "866-727-9116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "GABRIEL",
"middle_name": "EMMANUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-25",
"last_updated": "2024-10-25",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "AZ",
"license": "30208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Casa Grande, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.