Active NPI
Mary Grace Aguilar Santos, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Sinajana, GU
National Provider Identifier
1669647772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- M-1792
- Practice address
- 736 Route 4
Suite 103
Sinajana, GU 96910-3368 - Phone
- (671) 649-7232
- Fax
- (671) 649-7233
- NPI assigned
- Apr 29, 2008
- Last updated
- Jul 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125052317 | IL | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | M-1792 | GU | Primary |
Addresses
Primary practice location
736 Route 4
Suite 103
Sinajana, GU 96910-3368
Mailing address
736 Route 4
Suite 103
Sinajana, GU 96910-3368
Phone (671) 649-7232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125052317 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Eyecare, LLC | Past | Accepting new patients |
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": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1669647772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 ROUTE 4",
"address_2": "SUITE 103",
"city": "SINAJANA",
"state": "GU",
"postal_code": "969103368",
"telephone_number": "671-649-7232",
"fax_number": "671-649-7233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 ROUTE 4",
"address_2": "SUITE 103",
"city": "SINAJANA",
"state": "GU",
"postal_code": "969103368",
"telephone_number": "671-649-7232",
"fax_number": "671-649-7233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "MARY GRACE",
"middle_name": "AGUILAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125052317",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "GU",
"license": "M-1792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sinajana, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.