Individual provider Active NPI

Antonio Santiago-Agostini, MD

  • Internal Medicine Physician
  • Owosso, MI
National Provider Identifier
1801834445
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301054955 Issued in MI
Practice address
300 Health Park Dr Ste 302
Owosso, MI 48867-1293
Phone
(989) 723-5540
Fax
(989) 720-2292
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301054955 MI Primary

Addresses

Primary practice location

300 Health Park Dr Ste 302
Owosso, MI 48867-1293

Mailing address

300 Health Park Dr Ste 302
Owosso, MI 48867-1293
Phone (989) 723-5540

Other identifiers 1

IdentifierTypeStateIssuer
1801834445MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060426000064 MI Practitioner - Internal Medicine 4082624812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

300 Health Park Dr
Suite 302
Owosso, MI 48867-1293
Phone (989) 723-5540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
58.15
Promoting interoperability
100
Improvement activities
40
Cost
74.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301054955MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Mid-Michigan Behavioral Health, PC Past Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

300 Health Park Dr
Ste 302
Owosso, MI 48867
Phone (989) 723-5540

1488 N M 52
Owosso, MI 48867
Phone (989) 725-8124

818 W King St
Ste 101
Owosso, MI 48867
Phone (989) 723-1390

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Interoperability endpoints

  • Direct secure messaging: a.santiago@memorialhealthcare.midirect.net
  • Direct secure messaging: antoniosantiago@memh.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1801834445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK DR STE 302",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671293",
            "telephone_number": "989-723-5540",
            "fax_number": "989-720-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK DR STE 302",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671293",
            "telephone_number": "989-723-5540",
            "fax_number": "989-720-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-AGOSTINI",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301054955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801834445",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.