Individual provider Active NPI

Elsa Ivonn Santellano, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Laredo, TX
National Provider Identifier
1952021545
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1090272 Issued in TX
Practice address
1405 Jacaman Rd Ste 104
Laredo, TX 78041-6225
Phone
(956) 727-3047
Fax
(956) 717-3630
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1090272 TX Primary

Addresses

Primary practice location

1405 Jacaman Rd Ste 104
Laredo, TX 78041-6225

Mailing address

1405 Jacaman Rd Ste 104
Laredo, TX 78041-6225
Phone (956) 727-3047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920002893 TX Practitioner - Nurse Practitioner 9830574359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1090272TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Border Clinic PLLC CurrentSince Sep 6, 2022 Accepting new patients
Border Clinic, PA PastSince Sep 4, 2022 Accepting new patients

Locations

1405 Jacaman Rd
Ste 104
Laredo, TX 78041
Phone (956) 718-9767

1310 Trey Dr
Laredo, TX 78041
Phone (956) 727-3047

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGEEBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1952021545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 JACAMAN RD STE 104",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416225",
            "telephone_number": "956-727-3047",
            "fax_number": "956-717-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 JACAMAN RD STE 104",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416225",
            "telephone_number": "956-727-3047",
            "fax_number": "956-717-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTELLANO",
        "first_name": "ELSA",
        "middle_name": "IVONN",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1090272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.