Individual provider Active NPI

Marcus Santiago Cervantes, MD

  • Occupational Medicine Physician
  • Morgantown, WV
National Provider Identifier
1982124384
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
31528 Issued in WV
Practice address
390 Birch St
Morgantown, WV 26506-1102
Phone
(304) 293-3693
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301112863 MI
Occupational Medicine Physician 2083X0100X 31528 WV Primary

Addresses

Primary practice location

390 Birch St
Morgantown, WV 26506-1102

Mailing address

1200 E Michigan Ave Ste 245
Lansing, MI 48912-1897
Phone (517) 364-5252

Other practice location 1

1200 E Michigan Ave Ste 245
Lansing, MI 48912-1897
Phone (517) 364-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20220818000648 WV Practitioner - Family Practice 8628451044 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301112863MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jul 11, 2022 Accepting new patients
West Virginia University Medical Corporation Family Medicine CurrentSince Jul 11, 2022 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

390 Birch St
Morgantown, WV 26506
Phone (304) 285-7200

Interoperability endpoints

  • Direct secure messaging: mcervantes309014@direct.wvuhsdirect.com

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1982124384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 245",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121897",
            "telephone_number": "517-364-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 BIRCH ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061102",
            "telephone_number": "304-293-3693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Michigan Ave Ste 245",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121897",
            "country_code": "US",
            "telephone_number": "517-364-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "MARCUS",
        "middle_name": "SANTIAGO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301112863",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WV",
            "license": "31528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.