Individual provider Active NPI

Iris Myriam Marengo Santiago

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1659070878
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
24107 Issued in PR
Practice address
Colinas del Sol II 45 Calle 4 Apt 4511
Bayamon, PR 00957-7013
Phone
(787) 730-3446
NPI assigned
Feb 27, 2023
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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 24107 PR Primary

Addresses

Primary practice location

Colinas del Sol II 45 Calle 4 Apt 4511
Bayamon, PR 00957-7013

Mailing address

RR 14 Box 5334
Bayamon, PR 00956-9711
Phone (787) 730-3446

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
I20250214003340 PR Practitioner - General Practice 1052841384 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24107PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dajaos Medical Center CSP CurrentSince Jan 29, 2025 Accepting new patients

Locations

5334 RR 14
Bayamon, PR 00956
Phone (787) 279-3632

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1659070878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 14 BOX 5334",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009569711",
            "telephone_number": "787-730-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLINAS DEL SOL II 45 CALLE 4 APT 4511",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009577013",
            "telephone_number": "787-730-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARENGO SANTIAGO",
        "first_name": "IRIS",
        "middle_name": "MYRIAM",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.