Individual provider Active NPI

Kristin Jean Santangelo, M.D.

  • Urology Physician
  • Thousand Oaks, CA
National Provider Identifier
1629015474
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A79294 Issued in CA
Practice address
415 Rolling Oaks Dr
Suite 260
Thousand Oaks, CA 91361-1029
Phone
(805) 371-3770
Fax
(805) 371-4714
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A79294 CA Primary

Addresses

Primary practice location

415 Rolling Oaks Dr
Suite 260
Thousand Oaks, CA 91361-1029

Mailing address

415 Rolling Oaks Dr
Suite 260
Thousand Oaks, CA 91361-1029
Phone (805) 371-3770

Other identifiers 1

IdentifierTypeStateIssuer
6609636MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050909000583 CA Practitioner - Urology 0042242042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
George Washington University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

415 Rolling Oaks Dr
Suite 260
Thousand Oaks, CA 91361-1033
Phone (805) 371-3770

Hospital & facility affiliations

  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79294CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kristin J. Santangelo, MD, a Professional Corporation Urology CurrentSince Aug 5, 2005 Accepting new patients

Locations

415 Rolling Oaks Dr
Ste 260
Thousand Oaks, CA 91361
Phone (805) 371-4700

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1629015474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DR",
            "address_2": "SUITE 260",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611029",
            "telephone_number": "805-371-3770",
            "fax_number": "805-371-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DR",
            "address_2": "SUITE 260",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611029",
            "telephone_number": "805-371-3770",
            "fax_number": "805-371-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANGELO",
        "first_name": "KRISTIN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A79294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6609636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.