Individual provider Active NPI

Ada L Santos

  • General Practice Physician
  • Corozal, PR
National Provider Identifier
1902814817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15178 Issued in PR
Practice address
Carretera # 159 KM 13.0
Salida Ahacia
Corozal, PR 00783
Phone
(787) 802-0605
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15178 PR Primary

Addresses

Primary practice location

Carretera # 159 KM 13.0
Salida Ahacia
Corozal, PR 00783

Mailing address

PO Box 407
Corozal, PR 00783
Phone (787) 802-0605

Other identifiers 6

IdentifierTypeStateIssuer
22083SAOtherSSS
04271OtherAMERICAN HEALTH
2011424OtherPREFFERRED HEALTH
3958OtherPREFERRED MEDICAL CHOICE
A465OtherFIRST MEDICAL
7830029OtherHUMANA

Other names 1

  • Ada L Santos Professional name

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
I20040303000574 PR Practitioner - General Practice 6406743434 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15178PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Integral En la Montana, Inc CurrentSince Jan 15, 2021 Accepting new patients

Organizations & group practices 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902814817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-802-0605",
            "fax_number": "787-802-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA # 159 KM 13.0",
            "address_2": "SALIDA AHACIA",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-802-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ADA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "22083SA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH",
            "identifier": "04271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERRED HEALTH",
            "identifier": "2011424",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICAL CHOICE",
            "identifier": "3958",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "A465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "7830029",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADA",
            "last_name": "SANTOS",
            "middle_name": "L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Corozal, PR

Sources for this page

Verify at the official NPI Registry.