Individual provider Active NPI

Saul Omar Santiago Rodriguez

  • Emergency Medicine Physician
  • Caguas, PR
National Provider Identifier
1831724632
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23710 Issued in PR
Practice address
4G33 Calle 3a
Villa del Rey 4
Caguas, PR 00727-6808
Phone
(787) 518-7874
NPI assigned
Mar 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 23710 PR Primary

Addresses

Primary practice location

4G33 Calle 3a
Villa del Rey 4
Caguas, PR 00727-6808

Mailing address

4G33 Calle 3a
Caguas, PR 00727-6808
Phone (787) 518-7874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20240723004945 PR Practitioner - Emergency Medicine 4981140134 Reassigns benefits to 1 organization
Practice locations: Guayama, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23710PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sos Acute Care LLC Emergency Medicine CurrentSince Jul 4, 2024 Accepting new patients
Axtmayer MD LLC Emergency Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1831724632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4G33 CALLE 3A",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007276808",
            "telephone_number": "787-518-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4G33 CALLE 3A",
            "address_2": "VILLA DEL REY 4",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007276808",
            "telephone_number": "787-518-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO RODRIGUEZ",
        "first_name": "SAUL",
        "middle_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-12",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "23710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.