Xaira Ivette Mateo Santiago, SPEECH LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4027 Issued in PR

Practice address

1935 Ave Las Americas
Urb San Antonio
Ponce, PR 00728

Phone

(787) 843-7808

Fax

(787) 813-0798

NPI assigned

Sep 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1760901250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9016",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007329016",
            "telephone_number": "787-843-7808",
            "fax_number": "787-813-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 AVE LAS AMERICAS",
            "address_2": "URB SAN ANTONIO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00728",
            "telephone_number": "787-843-7808",
            "fax_number": "787-813-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO SANTIAGO",
        "first_name": "XAIRA",
        "middle_name": "IVETTE",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "4027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "4027",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristie Marie Massari Santos, PHARM D
• Anthony Massol Ortiz
• Jose Francisco Mata Gil, MS
• Milagros Marie Mateo Alvarado, DPT
• Cely Ann Mateo Cruz
• Zulma E Mateo Vazquez
• Yadira G Mateo, M.D.
• Ana Teresa Mateu
• Rafael A Mateu, DMD
• Jose Luis Matias Sr., PA

• Speech-Language Pathologist in Ponce, PR
• Providers in Ponce, PR by specialty
• Speech-Language Pathologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.