Active NPI
Raul Asasouk Santiago III, PHARMD, BCPS, BCIDP
- Pharmacist
- Boston, MA
National Provider Identifier
1881006856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH234641
- Practice address
- 1153 Centre St
Pharmacy
Boston, MA 02130-3446 - Phone
- (617) 983-7247
- NPI assigned
- May 27, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH234641 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Pharmacy
Boston, MA 02130-3446
Mailing address
1153 Centre St
Pharmacy
Boston, MA 02130-3446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MCS000091P | Other | MA | MASSACHUSETTS CONTROLLED SUBSTANCES REGISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH234641 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1881006856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "PHARMACY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "PHARMACY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-7247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "RAUL",
"middle_name": "ASASOUK",
"name_suffix": "III",
"credential": "PHARMD, BCPS, BCIDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-27",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH234641",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSETTS CONTROLLED SUBSTANCES REGISTRATION",
"identifier": "MCS000091P",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.