Individual provider Active NPI

Kenneth M Santos, D.O.

  • Anesthesiology Physician
  • Syracuse, NY
National Provider Identifier
1821029679
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
221527-1 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1807
Phone
(315) 299-5451
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 221527-1 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5564

Other identifiers 1

IdentifierTypeStateIssuer
02168674MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090309000246 NY Practitioner - Anesthesiology 5698831204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph'S Physician Health PCGroup PAC ID 9436041431, 125 clinicians

Practice addresses (Care Compare)

104 Union Ave
806 807
Syracuse, NY 13203-1843
Phone (315) 422-4442

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221527-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Physician Health, P.C. Anesthesiology CurrentSince Jan 1, 2009 Accepting new patients
St Josephs Medical PC CurrentSince Apr 14, 2018 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients
North Medical PC Past Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

Interoperability endpoints

  • Direct secure messaging: ksantos2389808@direct.trinity-health.org

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.

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1821029679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-299-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "221527-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02168674",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.