Ernestina S De Los Santos Mac, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301032311 Issued in MI

Practice address

633 South Blvd E Ste 2400
Rochester Hills, MI 48307

Phone

(248) 879-5570

Fax

(248) 879-2235

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ernestina S Mac Other name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14995/brand/1/csg/1/fhir/r4

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.

• Pediatric Consultants of Troy, P.C.

  • Pediatrics Physician
  • Rochester Hills, MI
  • NPI 1003821661
  NPD

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1972590677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 SOUTH BLVD E STE 2400",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075471",
            "telephone_number": "248-879-5570",
            "fax_number": "248-879-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 SOUTH BLVD E STE 2400",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-879-5570",
            "fax_number": "248-879-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44199 Dequindre Rd",
            "address_2": "Suite 222",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-879-5570",
            "fax_number": "248-879-2235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50720 Schoenherr Road",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483151128",
            "country_code": "US",
            "telephone_number": "586-566-2340",
            "fax_number": "586-566-4425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LOS SANTOS MAC",
        "first_name": "ERNESTINA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301032311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERNESTINA",
            "last_name": "MAC",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatrics Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.