Individual provider Active NPI

Victor J Santiago, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pomona, CA
National Provider Identifier
1851711568
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A168580 Issued in CA
Practice address
1798 N Garey Ave
Pomona, CA 91767-2918
Phone
(909) 865-9500
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A168580 CA Primary

Addresses

Primary practice location

1798 N Garey Ave
Pomona, CA 91767-2918

Mailing address

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500

Other practice location 1

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (866) 724-4127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201022002311 CA Practitioner - Pathology 0840594164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PVCH Clinical Laboratory Medical Group IncGroup PAC ID 8820050339, 3 clinicians

Practice addresses (Care Compare)

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9800

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168580CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PVCH Clinical Laboratory Medical Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2020 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

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.

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1851711568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1798 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672918",
            "telephone_number": "909-865-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672918",
            "telephone_number": "909-865-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 E Bonita Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671923",
            "country_code": "US",
            "telephone_number": "866-724-4127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "VICTOR",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A168580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.