Organization Active NPI

Gastroenterology Associates of St Augustine, PA

  • Gastroenterology Physician
  • St Augustine, FL
National Provider Identifier
1871554634
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF ST AUGUSTINE, PA
Practice address
216 Southpark Cir E
St Augustine, FL 32086-5135
Phone
(904) 824-6108
Fax
(904) 823-9613
NPI assigned
Mar 31, 2006
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Dr. Santiago A Rosado, M.D.NPI 1386618635
Title
President
Phone
(904) 824-6108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

216 Southpark Cir E
St Augustine, FL 32086-5135

Mailing address

216 Southpark Cir E
St Augustine, FL 32086-5135
Phone (904) 824-6108

Other identifiers 1

IdentifierTypeStateIssuer
056279300MedicaidFL

National Provider Directory

National Provider Directory

Locations

1633 Race Track Rd
Ste 206
Saint Johns, FL 32259
Phone (904) 824-6108

212 Southpark Cir E
St Augustine, FL 32086
Phone (904) 730-1131

216 Southpark Cir E
St Augustine, FL 32086
Phone (904) 824-6108

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1871554634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865135",
            "telephone_number": "904-824-6108",
            "fax_number": "904-823-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865135",
            "telephone_number": "904-824-6108",
            "fax_number": "904-823-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES OF ST AUGUSTINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "ROSADO",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-824-6108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056279300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.