NPIMap

Individual provider Active NPI

Sojeong Esther Santana, PA

  • Physician Assistant
  • Evans, CO
National Provider Identifier
1982367876
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007145 Issued in CO
Practice address
2930 11TH Ave
Evans, CO 80620-1011
Phone
(970) 353-9403
Fax
(970) 353-5884
NPI assigned
Oct 18, 2021
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007145 CO Primary

Addresses

Primary practice location

2930 11TH Ave
Evans, CO 80620-1011

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220223002560 CO Practitioner - Physician Assistant 3072907732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

302 3Rd St SE
Suite 150
Loveland, CO 80537-6419
Phone (970) 669-4855

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0007145COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Jul 25, 2022 Accepting new patients
Sunrise Community Health CurrentSince Jul 25, 2022 Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Interoperability endpoints

  • Direct secure messaging: sojeong.kwag.1@27043.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1982367876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-353-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "SOJEONG",
        "middle_name": "ESTHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, CO

Sources for this page

Verify at the official NPI Registry.