DR. CYNTHIA SANTIAGO M.D.
NPI 1003003856
Family Medicine in Port Jefferson Station, NY


Quality Rating: 92.05 out of 100 score

NPI Status: Active since September 26, 2007

Contact Information

5 ROOSEVELT AVE
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 732-6984
Fax: (631) 732-7019

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  • Individual
  • Female
  • Years of Experience 27
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About CYNTHIA SANTIAGO

Cynthia Santiago is a primary care provider established in Port Jefferson Station, New York and her medical specialization is Family Medicine with more than 27 years of experience. She graduated from New York University School Of Medicine in 1997. The healthcare provider is registered in the NPI registry with number 1003003856 assigned on September 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 217808 (NY). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI1003003856
Provider NameDR. CYNTHIA SANTIAGO M.D.
Location Address5 ROOSEVELT AVE PORT JEFFERSON STATION, NY 11776
Location Phone(631) 732-6984
Mailing Address5 ROOSEVELT AVE PORT JEFFERSON STATION, NY 11776
GenderFemale
Entity TypeIndividual
Medical School NameNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1997
Is Sole Proprietor?Yes
Enumeration Date09-26-2007
Last Update Date12-19-2014
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A primary care provider (PCP) like Cynthia Santiago sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Cynthia Santiago is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.05, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The following quality measures were reported for this provider: e-prescribing, immunization registry reporting, medication reconciliation, patient-specific education, provide patient access, secure messaging and security risk analysis.

The typical physician office visit costs for Medicare beneficiaries in this area are: $27.39 for a new patient copayment and $31.16 for an established patient copayment.

Location Map

Mailing Address

5 ROOSEVELT AVE
PORT JEFFERSON STATION, NY
ZIP 11776
Phone: (631) 732-6984
Fax: (631) 732-7019

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code207Q00000X
TypeAllopathic & Osteopathic Physicians
License No.217808
License StateNY
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
32V261MEDICARE PIN (08)NY 
02162494MEDICAID (05)NY 
H37637MEDICARE UPIN (02)NY 

PECOS Enrollment and Medicare Participation Status

Cynthia Santiago is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6305813148

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040913000368

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 11776 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $109.58
  • Minimum New Patient Price $71.49
  • Maximum New Patient Price $215.02
  • Average New Patient Copayment $27.39
  • Minimum New Patient Copayment $17.87
  • Maximum New Patient Copayment $53.75

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $124.65
  • Minimum Established Patient Price $22.05
  • Maximum Established Patient Price $174.06
  • Average Established Patient Copayment $31.16
  • Minimum Established Patient Copayment $5.51
  • Maximum Established Patient Copayment $43.51

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.05 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 90.41

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 89.5

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
e-Prescribing 97% 1349
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation 100% 23
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 27% 499
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 54% 499
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 27% 499
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 439

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 225

    Insertion of needle into vein for collection of blood sample (HCPCS:36415)

  • 205

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 112

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 49

    Administration of pneumococcal vaccine (HCPCS:G0009)

  • 38

    Measurement and graphic recording of total and timed exhaled air capacity (HCPCS:94010)

  • 26

    Automated urinalysis test (HCPCS:81003)

  • 26

    Hemoglobin a1c level (HCPCS:83036)

  • 14

    Urinalysis, manual test (HCPCS:81002)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Cynthia Santiago is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
(631) 473-1320Acute Care Hospitals
ST CHARLES HOSPITAL200 BELLE TERRE ROAD
PORT JEFFERSON, NY 11777
(631) 474-6000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003003856
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003006810
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 6 + 8 + 1 + 0 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003003856 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1801982822NORTH OCEAN FAMILY MEDICINE
Organization
Family Medicine5 ROOSEVELT AVE
PORT JEFFERSON STATION, NY 11776
(631) 732-6984

Frequently Asked Questions

What is Dr. Cynthia Santiago M.D. NPI number?

The NPI number assigned to this healthcare provider is 1003003856, enumerated in the NPI registry as an "individual" on September 26, 2007

Where is the provider located?

The provider is located at 5 Roosevelt Ave Port Jefferson Station, Ny 11776 and the phone number is (631) 732-6984

What is the provider specialty code?

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

How many years of experience does Dr. Cynthia Santiago M.D. have?

The provider has more than 27 years of experience. She graduated from New York University School Of Medicine in 1997.

What insurance does Dr. Cynthia Santiago M.D. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Dr. Cynthia Santiago M.D. registered in PECOS?

Yes, as of February 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What are Dr. Cynthia Santiago M.D. Quality Ratings?

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

How much is a visit to Dr. Cynthia Santiago M.D.?

Medicare beneficiaries should expect a typical cost of $109.58 with an average copayment of $27.39 for new patient appointments. Established patients should expect a typical charge of $124.65 and an average copayment of 31.16. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Dr. Cynthia Santiago M.D.?

The most common procedures or services performed by this practitioner are: Routine ekg using at least 12 leads including interpretation and report, Insertion of needle into vein for collection of blood sample, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Measurement and graphic recording of total and timed exhaled air capacity, Automated urinalysis test, Hemoglobin a1c level and Urinalysis, manual test.

Is Dr. Cynthia Santiago M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospital(s): JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON and ST CHARLES HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

This NPI record was last updated on September 26, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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