Active NPI
Teodoro Santiago
- Pulmonary Disease Physician
- New Brunswick, NJ
National Provider Identifier
1972676534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MA27029
- Practice address
- 125 Paterson St
Clinical Academic Building - Suite 5200B
New Brunswick, NJ 08901-1962 - Phone
- (732) 235-6511
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | MA27029 | NJ | Primary |
Addresses
Primary practice location
125 Paterson St
Clinical Academic Building - Suite 5200B
New Brunswick, NJ 08901-1962
Mailing address
66 W Gilbert St
2ND Floor
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1786300 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA27029 | NJ | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rutgers Health-RWJ Scleroderma Program | Past | Accepting new patients | |
| Rutgers Health-RWJ Scleroderma Program | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202083200000",
"number": "1972676534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 W GILBERT ST",
"address_2": "2ND FLOOR",
"city": "TINTON FALLS",
"state": "NJ",
"postal_code": "077014947",
"telephone_number": "732-212-0051",
"fax_number": "732-212-0713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 PATERSON ST",
"address_2": "CLINICAL ACADEMIC BUILDING - SUITE 5200B",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089011962",
"telephone_number": "732-235-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "TEODORO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2008-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NJ",
"license": "MA27029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1786300",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.