NPIMap

Individual provider Active NPI

Alejandra De Santiago, D.O.

  • Family Medicine Physician
  • Anadarko, OK
National Provider Identifier
1730613522
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6398 Issued in OK
Practice address
718 W Petree Rd
Anadarko, OK 73005-6024
Phone
(405) 632-6688
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6398 OK Primary

Addresses

Primary practice location

718 W Petree Rd
Anadarko, OK 73005-6024

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other practice location 1

111 W Main St
Ft Cobb, OK 73038
Phone (405) 632-6688

Other practice location 2

201 W 1st St
Grandfield, OK 73546
Phone (405) 632-6688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807001915 OK Practitioner - Family Practice 7012332000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

2002 N Council Ave
Blanchard, OK 73010-8038
Phone (405) 485-4701

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6398OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC Family Medicine CurrentSince Jan 27, 2024 Accepting new patients
Saints Medical Group, LLC CurrentSince Jan 27, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

2002 N Council Ave
Blanchard, OK 73010
Phone (405) 485-4701

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

Interoperability endpoints

  • Direct secure messaging: adesantiago206374@direct-ehr-ssmhc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1730613522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 W PETREE RD",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730056024",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Main St",
            "address_purpose": "LOCATION",
            "city": "Ft Cobb",
            "state": "OK",
            "postal_code": "73038",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Grandfield",
            "state": "OK",
            "postal_code": "73546",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE SANTIAGO",
        "first_name": "ALEJANDRA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anadarko, OK

Sources for this page

Verify at the official NPI Registry.