Active NPI
Eliezer Torres Santiago
- Psychologist
- Dorado, PR
National Provider Identifier
1891259784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301
- Practice address
- 188 Calle Norte
Dorado, PR 00646-2743 - Phone
- (787) 278-8888
- Fax
- (787) 278-8888
- NPI assigned
- Jan 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301 | PR | Primary |
Addresses
Primary practice location
188 Calle Norte
Dorado, PR 00646-2743
Mailing address
HH5 Calle Pelicano
Urb. Dorado del Mar
Dorado, PR 00646
Phone (787) 342-1302
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6301 | Other | PR | PSICOLOGIST LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190329001888 | PR | Practitioner - Psychologist Billing Independently | 7719227701 | Practice locations: Dorado, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301 | PR | MD | Pediatric Emergency Medicine (Emergency Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1891259784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HH5 CALLE PELICANO",
"address_2": "URB. DORADO DEL MAR",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-342-1302",
"fax_number": "787-278-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 CALLE NORTE",
"city": "DORADO",
"state": "PR",
"postal_code": "006462743",
"telephone_number": "787-278-8888",
"fax_number": "787-278-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORRES SANTIAGO",
"first_name": "ELIEZER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-25",
"last_updated": "2022-03-15",
"certification_date": "2022-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "6301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSICOLOGIST LICENCE",
"identifier": "6301",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorado, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.