Douglas Santiago, is a medicare enrolled "Audiologist" provider in Coolidge, Arizona. His current practice location is
4713 West Ginger Avenue, Coolidge, Arizona. You can reach out to his office (for appointments etc.) via phone at
(480) 748-5702.
Douglas Santiago is licensed to practice in Arizona (license number DA6557) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962682203.
Healthcare Provider's Profile
| Full Name | Douglas Santiago |
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| Gender | Male |
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| Speciality | Audiologist |
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| Location | 4713 West Ginger Avenue, Coolidge, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962682203
- Provider Enumeration Date: 11/04/2007
- Last Update Date: 08/09/2012
Medicare PECOS Information:
- PECOS PAC ID: 4981924214
- Enrollment ID: I20230828000125
Medical Identifiers
Medical identifiers for Douglas Santiago such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962682203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 231H00000X | Audiologist | DA6557 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Douglas Santiago allows following entities to bill medicare on his behalf.
| Provider Name | Hearx West Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1356398598
PECOS PAC ID: 3577535624
Enrollment ID: O20180713002238 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Douglas Santiago is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Douglas Santiago,
4713 W Ginger Ave,
Coolidge, AZ 85128-8286
Ph: (480) 748-5702 | Douglas Santiago,
4713 West Ginger Avenue,
Coolidge, AZ 85128
Ph: (480) 748-5702 |
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