Individual provider Active NPI

Engilberta Remo Santos, MD

  • Internal Medicine Physician
  • Woodside, NY
National Provider Identifier
1629178710
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
163739 Issued in NY
Practice address
4011 59 St
Woodside, NY 11377
Phone
(718) 533-1000
Fax
(718) 446-6163
NPI assigned
Sep 25, 2006
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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 163739 NY Primary

Addresses

Primary practice location

4011 59 St
Woodside, NY 11377

Mailing address

4011 59 St
Woodside, NY 11377
Phone (718) 533-1000

Other identifiers 1

IdentifierTypeStateIssuer
00909480MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090218000259 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1951466390 Practice locations: Woodside, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4011 59TH St
Woodside, NY 11377-4837
Phone (718) 533-1000

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1629178710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 59 ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "11377",
            "telephone_number": "718-533-1000",
            "fax_number": "718-446-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 59 ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "11377",
            "telephone_number": "718-533-1000",
            "fax_number": "718-446-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ENGILBERTA",
        "middle_name": "REMO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "163739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00909480",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.