Individual provider Active NPI

Alberto Maximino Llaneza Santacruz, M.D.

  • Family Medicine Physician
  • Youngstown, OH
National Provider Identifier
1811563547
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57.251351 Issued in OH
Practice address
2031 Belmont Ave
Youngstown, OH 44505-2401
Phone
(330) 480-3605
Fax
(330) 480-2948
NPI assigned
Jun 2, 2021
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 70951 TN
Family Medicine Physician 207Q00000X 57.251351 OH Primary

Addresses

Primary practice location

2031 Belmont Ave
Youngstown, OH 44505-2401

Mailing address

2031 Belmont Ave
Youngstown, OH 44505-2401
Phone (330) 480-3605

Other practice location 1

718 Harbor Bend Rd
Memphis, TN 38103-0888
Phone (901) 515-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240813003511 TN Practitioner - Family Practice 7911304720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

718 Harbor Bend Rd
Memphis, TN 38103-0888
Phone (901) 515-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Family Medicine CurrentSince Jul 6, 2024 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Jul 6, 2024 Accepting new patients

Locations

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

718 Harbor Bend Rd
Memphis, TN 38103
Phone (901) 515-4200

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Organizations & group practices 2

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 1

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1811563547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052401",
            "telephone_number": "330-480-3605",
            "fax_number": "330-480-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052401",
            "telephone_number": "330-480-3605",
            "fax_number": "330-480-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Harbor Bend Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381030888",
            "country_code": "US",
            "telephone_number": "901-515-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLANEZA SANTACRUZ",
        "first_name": "ALBERTO MAXIMINO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "70951",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57.251351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.