Active NPI
Kimberly Santo, PA
- Physician Assistant
- Stanford, CA
National Provider Identifier
1891276846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 62550
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- Aug 28, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 62550 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Other practice location 1
8260 Gladiolus Dr
Fort Myers, FL 33908-4156
Phone (239) 437-5755
Other practice location 2
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-3332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11059780 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62550 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1891276846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "8260 Gladiolus Dr",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339084156",
"country_code": "US",
"telephone_number": "239-437-5755",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9981 S Healthpark Dr",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339083618",
"country_code": "US",
"telephone_number": "239-343-3332",
"fax_number": "239-343-3966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTO",
"first_name": "KIMBERLY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "62550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11059780",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.