Individual provider Active NPI

Luis F Santamarina, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Olympia, WA
National Provider Identifier
1962452664
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD00038070 Issued in WA
Practice address
525 Lilly Rd NE Ste 200
PMG SW Wa Olympia Cardiac Surgery
Olympia, WA 98506-5101
Phone
(360) 493-4510
Fax
(360) 493-7759
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00038070 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD00038070 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE Ste 200
PMG SW Wa Olympia Cardiac Surgery
Olympia, WA 98506-5101

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
8251894MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsantamarina95306@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100716000184 WA Practitioner - Cardiac Surgery 3476685124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)38
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jul 1, 2013 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

525 Lilly Rd NE
Ste 200
Olympia, WA 98506
Phone (360) 493-4510

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 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1962452664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE STE 200",
            "address_2": "PMG SW WA OLYMPIA CARDIAC SURGERY",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-4510",
            "fax_number": "360-493-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAMARINA",
        "first_name": "LUIS",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00038070",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD00038070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8251894",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsantamarina95306@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "525 Lilly Rd NE Ste 200",
            "address_2": "PMG SW WA Olympia Cardiac Surgery",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.