Individual provider Active NPI

Jose A Santana, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1629174917
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0095767 Issued in FL
Practice address
3625 University Blvd S
Emergency Department
Jacksonville, FL 32202
Phone
(904) 399-6811
Fax
(904) 346-0113
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0095767 FL Primary

Addresses

Primary practice location

3625 University Blvd S
Emergency Department
Jacksonville, FL 32202

Mailing address

PO Box 860554
Orlando, FL 32886-0554
Phone (904) 346-3606

Other identifiers 2

IdentifierTypeStateIssuer
57005OtherBCBS
P00368778OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070316000360 FL Practitioner - Emergency MedicinePractitioner - Internal Medicine 7214951532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (800) 424-3672

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0095767FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Oliver Emergency Group, LLC CurrentSince Jun 16, 2022 Accepting new patients
Paragon Emergency Services LLC CurrentSince Jul 1, 2016 Accepting new patients
Lake Oliver Emergency Group, LLC CurrentSince Jun 16, 2022 Accepting new patients
Florida Em-I Medical Services, PA Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Emergency Medicine Physicians of Lenoir County PLLC Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

2674 Capital Cir SE
Tallahassee, FL 32311
Phone (850) 325-5888

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 6

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 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1629174917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860554",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328860554",
            "telephone_number": "904-346-3606",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32202",
            "telephone_number": "904-399-6811",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0095767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00368778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.