NPIMap

Individual provider Active NPI

Kenneth A Santiago, MD

  • Internal Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1801878186
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34596 Issued in SC
Practice address
9021 Bella Verde CT
Myrtle Beach, SC 29579-5110
Phone
(843) 516-2024
NPI assigned
Nov 14, 2005
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 212611 MA
Internal Medicine Physician 207R00000X 34596 SC Primary

Addresses

Primary practice location

9021 Bella Verde CT
Myrtle Beach, SC 29579-5110

Mailing address

PO Box 70157
Myrtle Beach, SC 29572-0021
Phone (843) 516-2024

Other identifiers 4

IdentifierTypeStateIssuer
2098075MedicaidMA
GP4505MedicaidSC
345969MedicaidSC
7844OtherSCMEDIARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120913000525 SC Practitioner - Internal Medicine 3072565431 Reassigns benefits to 4 organizations
Practice locations: Conway, SC
I20221222001073 GA Practitioner - Internal Medicine 3072565431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of South Carolina PCGroup PAC ID 1951672617, 226 clinicians
CH Specialty Services SC LLCGroup PAC ID 6608182993, 222 clinicians

Practice addresses (Care Compare)

255 Midland Pkwy
Summerville, SC 29485-8104
Phone (737) 226-6700

6650 Rivers Ave
North Charleston, SC 29406-4809
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34596SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health Medical Group LLC Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
CH Specialty Services SC LLC CurrentSince Jul 12, 2024 Accepting new patients
Curana Health of South Carolina PC Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Medicos, P.a. Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jul 1, 2012 Accepting new patients
Physician at Home, PC Current Accepting new patients
Grand Strand Regional Medical Center LLC Past Accepting new patients
New England Hospitalists PC Internal Medicine PastSince Oct 1, 2008 Accepting new patients
Senior Care of Marion LLC Past Accepting new patients
Bluebird Healthcare, Inc. PastSince Oct 1, 2022 Accepting new patients
Innovative Physician Services LLC Internal Medicine PastSince Jan 1, 2012 Accepting new patients

Locations

2541 Milledgeville Rd
Augusta, GA 30904
Phone (706) 735-2581

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

6650 Rivers Ave
North Charleston, SC 29406
Phone (843) 260-5361

506 2nd Ave N
North Myrtle Beach, SC 29582
Phone (843) 516-2024

255 Midland Pkwy
Summerville, SC 29485
Phone (843) 821-5005

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NHC Healthcare-Garden CityMurrells Inlet, SC, CCN 425324 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2019
May 1, 2019
Senior Care of Marion LLCMarion, SC, CCN 425416 Skilled nursing facility Adp of the SNF Nov 5, 2025
Oak View Health and RehabilitationConway, SC, CCN 425121 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Oct 1, 2022
Oct 1, 2022
Jun 26, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1801878186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70157",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295720021",
            "telephone_number": "843-516-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 BELLA VERDE CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795110",
            "telephone_number": "843-516-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "212611",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "34596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098075",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345969",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIARE GROUP PTAN",
            "identifier": "7844",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.