Individual provider Active NPI

Gabriel Emmanuel Santiago

  • Massage Therapist
  • Casa Grande, AZ
National Provider Identifier
1619799277
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
30208 Issued in AZ
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

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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

LicenseStateTypeSpecialty
30208AZMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Grande Community Acupuncture LLC Single Specialty CurrentSince Oct 27, 2024 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.

Verify at the official NPI Registry.