Individual provider Active NPI

Jose A Santiago Santiago, MD

  • Internal Medicine Physician
  • Penuelas, PR
National Provider Identifier
1891752440
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8333 Issued in PR
Practice address
602 Calle Jose V Rodriguez
Penuelas, PR 00624-1807
Phone
(787) 836-3288
Fax
(866) 626-2798
NPI assigned
Apr 27, 2006
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8333 PR Primary

Addresses

Primary practice location

602 Calle Jose V Rodriguez
Penuelas, PR 00624-1807

Mailing address

PO Box 10730
Ponce, PR 00732-0730
Phone (787) 836-3288

Other identifiers 1

IdentifierTypeStateIssuer
DE665ZOtherPRMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20050504000931 PR Practitioner - Internal Medicine 9335189893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro Ceski CSPGroup PAC ID 1456482868, 2 clinicians

Practice addresses (Care Compare)

602 Calle Jose V Rodriguez
Penuelas, PR 00624-1807
Phone (787) 836-3288

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Ceski C S P CurrentSince Jan 12, 2010 Accepting new patients
Ponce Medical School Foundation Inc Past Accepting new patients
Puerto Rico Health Care Group Internal Medicine Past Accepting new patients
Southern Health Care Group, Inc. Internal Medicine PastSince Oct 20, 2019 Accepting new patients

Locations

602 Calle Jose V Rodriguez
Penuelas, PR 00624
Phone (787) 836-3288

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1891752440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10730",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007320730",
            "telephone_number": "787-836-3288",
            "fax_number": "866-626-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CALLE JOSE V RODRIGUEZ",
            "city": "PENUELAS",
            "state": "PR",
            "postal_code": "006241807",
            "telephone_number": "787-836-3288",
            "fax_number": "866-626-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO SANTIAGO",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "8333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DE665Z",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penuelas, PR

Sources for this page

Verify at the official NPI Registry.