Individual provider Active NPI

Crystal R Santiago, APRN

  • Family Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1952724916
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9318395 Issued in FL
Practice address
4300 W Lake Mary Blvd
Ste 1010
Lake Mary, FL 32746-2449
Phone
(407) 732-7957
Fax
(407) 732-7925
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9318395 FL Primary

Addresses

Primary practice location

4300 W Lake Mary Blvd
Ste 1010
Lake Mary, FL 32746-2449

Mailing address

4300 W Lake Mary Blvd Ste 1010
Lake Mary, FL 32746-2449
Phone (407) 732-7957

Other practice location 1

8209 Natures Way Ste 115-117
Lakewood Ranch, FL 34202-4218
Phone (941) 388-8997

Other practice location 2

1700 S Tamiami Trl
Sarasota, FL 34239-3509
Phone (941) 917-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140916002223 FL Practitioner - Nurse Practitioner 6103045646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Healing Arts Medical Center, Inc. CurrentSince Jul 18, 2023 Accepting new patients
SMH Physician Services Inc CurrentSince Aug 24, 2020 Accepting new patients

Locations

2215 59th St W
#A
Bradenton, FL 34209
Phone (941) 761-4994

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952724916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W LAKE MARY BLVD STE 1010",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462449",
            "telephone_number": "407-732-7957",
            "fax_number": "407-732-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W LAKE MARY BLVD",
            "address_2": "STE 1010",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462449",
            "telephone_number": "407-732-7957",
            "fax_number": "407-732-7925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8209 Natures Way Ste 115-117",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342024218",
            "country_code": "US",
            "telephone_number": "941-388-8997",
            "fax_number": "941-306-5876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393509",
            "country_code": "US",
            "telephone_number": "941-917-8323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CRYSTAL",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9318395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.