NPIMap

Individual provider Active NPI

Manuel R Carrasco-Santiago, MD

  • Internal Medicine Physician
  • Big Spring, TX
National Provider Identifier
1932109196
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J5275 Issued in TX
Practice address
1501 W 11TH PL
Suite # 304
Big Spring, TX 79720-4119
Phone
(432) 714-4500
Fax
(432) 714-4502
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J5275 TX Primary
Psychiatric Hospital 283Q00000X J5275 TX

Addresses

Primary practice location

1501 W 11TH PL
Suite # 304
Big Spring, TX 79720-4119

Mailing address

1501 W 11TH PL
Suite # 304
Big Spring, TX 79720-4119
Phone (432) 714-4500

Other identifiers 1

IdentifierTypeStateIssuer
134103409MedicaidTX

Other names 1

  • Dr. Manuel R Carrasco-Santiago Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031219000194 TX Practitioner - Internal Medicine 6800793597 Reassigns benefits to 3 organizations
Practice locations: Big Spring, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group PLLCGroup PAC ID 0446296818, 189 clinicians

Practice addresses (Care Compare)

1601 W 11TH PL
Big Spring, TX 79720-4114
Phone (432) 263-1211

Hospital & facility affiliations

  • Excelacare Hospice Hospice, San Antonio, TX, CCN 671669
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132
  • Scenic Mountain Medical Center Hospital, Big Spring, TX, CCN 450653
  • Parkview Skilled Care and Rehabilitation Nursing home, Big Spring, TX, CCN 675462

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J5275TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission Current Accepting new patients
Covenant Medical Group Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Covenant Medical Group Past Accepting new patients
VCKB Management, LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mcarrasc@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Parkview Skilled Care and RehabilitationBig Spring, TX, CCN 675462 Skilled nursing facility Adp of the SNF Nov 1, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1932109196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W 11TH PL",
            "address_2": "SUITE # 304",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797204119",
            "telephone_number": "432-714-4500",
            "fax_number": "432-714-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W 11TH PL",
            "address_2": "SUITE # 304",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797204119",
            "telephone_number": "432-714-4500",
            "fax_number": "432-714-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO-SANTIAGO",
        "first_name": "MANUEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J5275",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TX",
            "license": "J5275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134103409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANUEL",
            "last_name": "CARRASCO-SANTIAGO",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Big Spring, TX

Sources for this page

Verify at the official NPI Registry.