Individual provider Active NPI

Jayson Geronimo Santiago

  • Acute Care Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1982248761
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95012332 Issued in CA
Practice address
30 Mark West Springs Rd
Santa Rosa, CA 95403-1436
Phone
(707) 334-9839
NPI assigned
Nov 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95012332 CA Primary

Addresses

Primary practice location

30 Mark West Springs Rd
Santa Rosa, CA 95403-1436

Mailing address

39 Toscana Dr
American Canyon, CA 94503-1470
Phone (707) 334-9839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200224001805 CA Practitioner - Nurse Practitioner 6002243557 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Assistant Surgical Assist IncGroup PAC ID 8123271749, 35 clinicians

Practice addresses (Care Compare)

1651 Creekside Dr
Suite 100
Folsom, CA 95630-3833
Phone (916) 673-1990

6520 Lonetree Blvd
Rocklin, CA 95765-5874

Hospital & facility affiliations

  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates CurrentSince Jun 9, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 9, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 9, 2021 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services Acute Care CurrentSince Jun 9, 2021 Accepting new patients
UCSF Dept of Surgery CurrentSince Jun 9, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 9, 2021 Accepting new patients
Physician Assistant Surgical Assist, Inc CurrentSince Jul 15, 2022 Accepting new patients
Regents of the University of California CurrentSince Jun 9, 2021 Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

1651 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (702) 458-2304

5 Bon Air Rd
Ste 100
Larkspur, CA 94939

6520 Lonetree Blvd
Ste 2009
Rocklin, CA 95765
Phone (702) 458-2304

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

1825 4th St
#4
San Francisco, CA 94143

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: jsantiago352294@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1982248761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 TOSCANA DR",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031470",
            "telephone_number": "707-334-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MARK WEST SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031436",
            "telephone_number": "707-334-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JAYSON",
        "middle_name": "GERONIMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.