Carissa Anne Sanjuan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

003031 Issued in GA

Practice address

401 Matthew St
Marietta, OH 45750-1635

Phone

(740) 374-7700

Fax

(740) 374-7701

NPI assigned

Jul 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, OH2 enrollments

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 2

Specialty

Family PracticeAlso: Hospitalist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
• Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Family Medicine

  NPD
• Phoebe Senior Center

  • Clinic/Center
  • Camilla, GA
  • NPI 1821394271
  NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721

  Family Medicine

  NPD (past)
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  NPD (past)
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Camden Campus

  • General Acute Care Hospital
  • Saint Marys, GA
  • NPI 1194744326
  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689838526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312060800",
            "telephone_number": "478-633-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-374-7700",
            "fax_number": "740-374-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJUAN",
        "first_name": "CARISSA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "003031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Noel Salvatore
• Barbara Jane Sampson, CCC-SLP
• Tiffany Faith Sampson, LPN
• Kenia Samuel, M.D.
• Roxana Sanchez, DDS
• Molly Sapp, LSW
• Chitra Sarpeshkar, RDCS, RDMS
• Jennifer Scalzo
• Kim L Schaum, FNP-BC
• Ben A Scheinfeld, M.D.

• Family Medicine Physician in Marietta, OH
• Providers in Marietta, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.