MARCUS G SANTANA MD
NPI 1194764217
Internal Medicine - Pulmonary Disease in North Miami Beach, FL

Q: What is Marcus Santana's NPI number?

The NPI number for Marcus Santana is 1194764217. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Q: What is Marcus Santana's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Marcus Santana was last updated on March 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 05, 2006PECOS EnrolledAccepts Medicare Assignment

98.06/100

CMS Quality Rating

100 NW 170TH ST STE 301, NORTH MIAMI BEACH, FL 33169(305) 651-3038(305) 655-1153 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 5, 2024, Sep 11, 2020, Apr 1, 2019 and 1 more (4 updates tracked since 2018).

On this page

About Marcus G Santana Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCUS G SANTANA MD (NPI 1194764217) is an individual pulmonary disease provider in North Miami Beach, Florida, licensed in Maine (MD24078) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with York Hospital, and maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1194764217

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameMARCUS G SANTANACredential: MD

Location Address100 NW 170TH ST STE 301North Miami Beach, FL 33169-5511

Mailing AddressPo Box 4100Lewiston, ME 04243-4100 · (207) 795-2237

Phone(305) 651-3038

Fax(305) 655-1153

Sole ProprietorYes

Medical School CMSOtherGraduated 1995

Enumeration DateJune 5, 2006

Last NPPES UpdateMarch 5, 20244 updates tracked since enumeration

NPPES CertifiedMarch 5, 2024

✔ NPI 1194764217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in ME · MD24078

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

100 NW 170TH ST STE 301, North Miami Beach, FL 33169

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Secondary Practice Location 1

Location 1700 S Park St, Dean St. Mary's Outpatient CenterMadison, WI 53715 · Phone (608) 260-2900 · Fax (608) 260-2951

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Oscar Health Maintenance Organization of Florida, Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marcus G Santana Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890715445

PECOS Enrollment IDI20201016001038

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Marcus Santana reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vincenzo Novara MD PA

Same address

Pulmonary Disease

100 NW 170TH ST, SUITE 301
North Miami Beach, FL 33169

Reassigned Medicare billing, Florida enrollment
30 clinicians in this Medicare group

NPI 1003004276 (305) 651-3033

York Hospital

1,303 mi

General Acute Care Hospital

15 HOSPITAL DR
York, ME 03909

Reassigned Medicare billing, Maine enrollment
347 clinicians in this Medicare group

NPI 1376528398 (207) 361-2398

Bridgton Hospital

1,358 mi

Critical Access

10 HOSPITAL DR
Bridgton, ME 04009

Reassigned Medicare billing, Maine enrollment
563 clinicians in this Medicare group

NPI 1154370153 (207) 795-5709

Central Maine Medical Center

1,372 mi

General Acute Care Hospital

300 MAIN ST
Lewiston, ME 04240

Reassigned Medicare billing, Maine enrollment
920 clinicians in this Medicare group

NPI 1689653487 (207) 795-5646

Rumford Community Family Health Center Inc.

1,392 mi

Specialist

431 FRANKLIN ST
Rumford, ME 04276

Reassigned Medicare billing, Maine enrollment
77 clinicians in this Medicare group

NPI 1699967224 (207) 364-7831

Rumford Hospital

1,392 mi

Critical Access

420 FRANKLIN ST
Rumford, ME 04276

Reassigned Medicare billing, Maine enrollment
544 clinicians in this Medicare group

NPI 1205991122 (207) 369-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

304 services181 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

128 services127 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

126 services125 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

111 services110 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

79 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

76 services67 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

74 services74 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

44 services28 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

16 services15 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

15 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

York Hospital

Acute Care Hospitals · York, ME

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200020

Location15 Hospital DriveYork, ME 03909 · York County

Emergency services Birthing friendly

Central Maine Medical Center

Acute Care Hospitals · Lewiston, ME

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200024

Location300 Main StreetLewiston, ME 04240 · Androscoggin County

Emergency services Birthing friendly

St Mary's Regional Medical Center

Acute Care Hospitals · Lewiston, ME

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number200034

Location93 Campus Avenue - PO Box 291Lewiston, ME 04243 · Androscoggin County

Emergency services

Rumford Hospital

Critical Access Hospitals · Rumford, ME

OwnershipProprietary

CMS Certification Number201306

Location420 Franklin StreetRumford, ME 04276 · Oxford County

Emergency services

Bridgton Hospital

Critical Access Hospitals · Bridgton, ME

OwnershipVoluntary non-profit - Private

CMS Certification Number201310

Location10 Hospital DriveBridgton, ME 04009 · Cumberland County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33169 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.06/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.13

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tracheal suction catheter, closed system, each A4605

DME-Other DME · category DE000N

1 supplier12 claims160 services$15.52 avg. paid by Medicare

Tracheostomy, inner cannula A4623

DME-Orthotic Devices · category DF000N

1 supplier12 claims360 services$6.34 avg. paid by Medicare

Oropharyngeal suction catheter, each A4628

DME-Other DME · category DE000N

1 supplier12 claims96 services$3.54 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier12 claims360 services$4.50 avg. paid by Medicare

Canister, disposable, used with suction pump, each A7000

DME-Other DME · category DE000N

1 supplier12 claims48 services$7.13 avg. paid by Medicare

Tubing, used with suction pump, each A7002

DME-Other DME · category DE000N

1 supplier12 claims96 services$3.15 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINA RAJIC PA-C

Physician Assistant (Medical)