Individual provider Active NPI

Eric David Santiago

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1689995508
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1190830 Issued in TX
Practice address
1117 Clear Lake City Blvd
Houston, TX 77062-8102
Phone
(832) 224-4735
Fax
(832) 224-4679
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1190830 TX Primary

Addresses

Primary practice location

1117 Clear Lake City Blvd
Houston, TX 77062-8102

Mailing address

1117 Clear Lake City Blvd
Houston, TX 77062-8102
Phone (832) 224-4735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120720000282 TX Practitioner - Physical Therapist in Private Practice 6103080239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1117 Clear Lake City Blvd
Houston, TX 77062-8102
Phone (832) 224-4735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1190830TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Physical Therapy Inc. Physical Therapist CurrentSince Feb 29, 2016 Accepting new patients

Locations

1117 Clear Lake City Blvd
Houston, TX 77062
Phone (832) 224-4735

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1689995508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 CLEAR LAKE CITY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770628102",
            "telephone_number": "832-224-4735",
            "fax_number": "832-224-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 CLEAR LAKE CITY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770628102",
            "telephone_number": "832-224-4735",
            "fax_number": "832-224-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1190830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.