Active NPI
Nicholas Joseph Santaniello, MD
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1679195234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD480700
- Practice address
- 3401 Civic Center Blvd
Division of General Pediatrics
Philadelphia, PA 19104 - Phone
- (215) 590-1220
- NPI assigned
- May 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD480700 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of General Pediatrics
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of General Pediatrics
Philadelphia, PA 19104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD480700 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Pediatrics | Current | Accepting new patients |
| Childen'S Health Care Associates Inc. | Current | Accepting new patients | |
| Childrens Health Care Associates, Inc | Pediatrics | Current | Accepting new patients |
Locations
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
3401 Civic Center Blvd
#M975
Philadelphia, PA 19104
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1598869059
-
- Pediatric Registered Nurse
- Philadelphia, PA
- NPI 1699860643
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1710072764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1679195234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF GENERAL PEDIATRICS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF GENERAL PEDIATRICS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-590-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTANIELLO",
"first_name": "NICHOLAS",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-17",
"last_updated": "2024-03-20",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD480700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.