Individual provider Active NPI

Luis Carlos Santaella, M.D

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1639408388
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17759 Issued in PR
Practice address
St. Rafael Jimenez de la Rosa #340 Urb. Reparto Olga
San Juan, PR 00926
Phone
(787) 717-3332
NPI assigned
Dec 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17759 PR Primary

Addresses

Primary practice location

St. Rafael Jimenez de la Rosa #340 Urb. Reparto Olga
San Juan, PR 00926

Mailing address

St. Rafael Jimenez de la Rosa #340 Urb. Reparto Olga
San Juan, PR 00926
Phone (787) 717-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20200713000136 PR Practitioner - General Practice 9234552068 Reassigns benefits to 1 organization
Practice locations: Comerio, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17759PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Menonita de Cayey CurrentSince Mar 26, 2021 Accepting new patients
Hospital Menonita de Cayey General Practice CurrentSince Mar 26, 2021 Accepting new patients

Organizations & group practices 2

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": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1639408388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST. RAFAEL JIMENEZ DE LA ROSA #340 URB. REPARTO OLGA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-717-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. RAFAEL JIMENEZ DE LA ROSA #340 URB. REPARTO OLGA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-717-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAELLA",
        "first_name": "LUIS",
        "middle_name": "CARLOS",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.