Individual provider Active NPI

Christine Suzanne Santos

  • Pediatrics Physician
  • Madera, CA
National Provider Identifier
1760748149
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A13162 Issued in CA
Practice address
9300 Valley Childrens PL # GW12
Madera, CA 93636-8761
Phone
(559) 353-5068
Fax
(559) 353-5426
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A13162 CA Primary

Addresses

Primary practice location

9300 Valley Childrens PL # GW12
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL # SC05
Madera, CA 93636-8761
Phone (559) 353-5068

Other identifiers 1

IdentifierTypeStateIssuer
1760748149MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150914000005 CA Practitioner - Pediatric Medicine 0446567143 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13162CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group Pediatrics CurrentSince Jul 20, 2015 Accepting new patients
Valley Children'S Specialty Medical Group, Inc. Pediatrics CurrentSince Jul 20, 2015 Accepting new patients
Valley Children'S Hospital PastSince Mar 22, 2020 Accepting new patients
Valley Children'S Hospital Past Accepting new patients

Locations

9300 Valley Childrens Pl
#5
Madera, CA 93636
Phone (559) 353-5700

9300 Valley Childrens Pl
#12
Madera, CA 93636
Phone (559) 353-5068

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Interoperability endpoints

  • Direct secure messaging: csantos15872@valleychildrens-prd.direct-ci.com

Organizations & group practices 4

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1760748149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # SC05",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5068",
            "fax_number": "559-353-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # GW12",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5068",
            "fax_number": "559-353-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "CHRISTINE",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A13162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760748149",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.