DR. JOSE S ABAD SANTOS M.D.
NPI 1144297730
Pediatrics in Sussex, WI
NPI Status: Active since March 02, 2006
Contact Information
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
Phone: (414) 566-6400
Fax: (414) 566-3866
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About JOSE ABAD SANTOS
This page provides the complete NPI Profile along with additional information for Jose Abad Santos, a pediatrician established in Sussex, Wisconsin with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1144297730 assigned on March 2006. The practitioner's primary taxonomy code is 208000000X with license number 34691-020 (WI). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1144297730
- Provider Name
- DR. JOSE S ABAD SANTOS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- W227N6103 SUSSEX RD SUSSEX, WI 53089
- Location Phone
- (414) 566-6400
- Location Fax
- (414) 566-3866
- Mailing Address
- W227N6103 SUSSEX RD SUSSEX, WI 53089
- Mailing Phone
- (414) 566-6400
- Mailing Fax
- (414) 566-3866
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-02-2006
- Last Update Date
- 01-15-2021
- Code Navigator
A pediatrician like Jose Abad Santos is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 34691-020
- License State
- WI
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Chorus Bronze Complete - EPO
- Chorus Bronze HDHP - EPO
- Chorus Catastrophic - EPO
- Chorus Core Bronze - EPO
- Chorus Core Gold - EPO
- Chorus Core Silver - EPO
- Chorus Elite Gold - EPO
- Chorus Gold - EPO
- Chorus Silver - EPO
- Chorus Silver Select - EPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold Essential + 3Free PCP Visits - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + 3 Free PCP Visits - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Signature Prestige Bronze $0 Deductible - HMO
- Signature Prestige Bronze $0 Deductible + Dental + Vision - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jose Abad Santos 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
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 53089 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* 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.
Reviews for DR. JOSE S ABAD SANTOS M.D.
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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. | |||||||||
| 1 | 1 | 4 | 4 | 2 | 9 | 7 | 7 | 3 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 8 | 4 | 4 | 9 | 14 | 7 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 8 + 4 + 4 + 9 + 1 + 4 + 7 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1144297730 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. CATHY CLEONE SMITH MD
Internal Medicine
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
DR. RANDAL LEONARD VOSTERS MD
Family Medicine
(Sports Medicine)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
DR. KIMBERLY L MCELROY M.D.
Pediatrics
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
JAMES M FRISVOLD D.O.
Family Medicine
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MRS. LINDA S VOGEL P.A
Physician Assistant
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MRS. LISA J MUELLER DPT
Physical Therapist
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
HALEE SHEPARD DPT
Physical Therapist
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MS. STEFANIE GABRIELLA JONES FNP
Nurse Practitioner
(Family)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MARY LOUISE DITORE
Registered Nurse
(Diabetes Educator)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
JENNIFER HARNACK RDN
Dietitian, Registered
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
KELLY GATHMAN CHES
Health Educator
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
KELLY M WEBSTER RDN
Health Educator
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
BRENDA DUNLAP LPC
Counselor
(Mental Health)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
QUAD/MED, LLC
Pharmacy
(Clinic Pharmacy)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
QUAD/MED, LLC
Clinic/Center
(Primary Care)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
KATHRYN WIRTZ PA
Physician Assistant
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
DONALD J. DALEY JR. N.P.
Nurse Practitioner
(Family)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
ELIZABETH A HARRINGTON RN, CDCES
Registered Nurse
(Diabetes Educator)
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MR. ROGER J HARGREAVES JR.
Pharmacist
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
MICHELLE KOSMALSKI MD
Family Medicine
W227N6103 SUSSEX RD
SUSSEX, WI
ZIP 53089
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144297730, enumerated as an "individual" on March 02, 2006.
The provider is located at W227N6103 SUSSEX RD SUSSEX, WI 53089 and the phone number is (414) 566-6400.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Chorus. Please consult your insurance carrier or call the provider to verify.
