NPIMap

Individual provider Active NPI

Jeremy Paul Dona Santiago, M.D.

  • Hospitalist Physician
  • El Paso, TX
National Provider Identifier
1841647104
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD61170590 Issued in WA
Practice address
2001 N Oregon St
El Paso, TX 79902
Phone
(915) 577-6011
NPI assigned
May 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61170590 WA
Internal Medicine Physician 207R00000X P32579 MD
Hospitalist Physician 208M00000X MD61170590 WA Primary

Addresses

Primary practice location

2001 N Oregon St
El Paso, TX 79902

Mailing address

2001 N Oregon St
El Paso, TX 79902-3320

Other practice location 1

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

Other practice location 2

2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-9386

Other identifiers 1

IdentifierTypeStateIssuer
2194918MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211028001206 WA Practitioner - Internal MedicinePractitioner - Hospitalist 6608166269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P32579MDMDInternal Medicine Physician
MD61170590WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Oct 25, 2021 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince Oct 25, 2021 Accepting new patients
Providence Health & Services Washington Internal Medicine Current Accepting new patients
Providence Health & Services Washington CurrentSince Oct 25, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Oct 25, 2021 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 7

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1841647104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N OREGON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N OREGON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79902",
            "telephone_number": "915-577-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 W Belvedere Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212155216",
            "country_code": "US",
            "telephone_number": "410-601-9386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JEREMY PAUL",
        "middle_name": "DONA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61170590",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P32579",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD61170590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2194918",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.