DR. GRACE ELLEN M SANTA TERESA (M.D.) – Emergency Medicine Physician, NPI 1104023399

DR. GRACE ELLEN M SANTA TERESA (M.D.) is a healthcare provider. based in Brandon, Mississippi. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 659-L (MS). The NPI Number for DR. GRACE ELLEN M SANTA TERESA (M.D.) is 1104023399

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. GRACE ELLEN M SANTA TERESA (M.D.)
NPI
1104023399
Phone
(601) 213-8633
Address
201 BINNACLE CT
Enumeration Date
29 June 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2056253511
Graduation Year
2005 (21 years ago)
PAC ID
6406980200
Group Practice PAC ID
3971417825
Professional Enrollment ID
I20161108002189
Address ID
AL351212827ON150XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

586 EMERGENCY MEDICINE in MS

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Provider Addresses for DR. GRACE ELLEN M SANTA TERESA (M.D.)

  • 201 BINNACLE CT

    BRANDON, MS 390477051

    Phone: (601) 213-8633

    Type: Mailing

  • University of Mississippi Medical Center, 2500, North State Street, Woodland Hills, Jackson, Hinds County, Mississippi, 39216, United States

    JACKSON, MS 392164500

    Phone: (601) 984-4000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-11-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100816000790IEmergency MedicineMSTBD
I20161108002189IEmergency MedicineALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making5047$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only3429$0
99284Emergency department visit with moderate level of medical decision making2826$0
View full utilization report →

Insurance plans in this area (ZIP 39047)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971417825View full group profile

Reviews

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Frequently asked questions

Is DR. GRACE ELLEN M SANTA TERESA (M.D.) listed with a National Provider Identifier?
Yes — DR. GRACE ELLEN M SANTA TERESA (M.D.) has NPI 1104023399 on file in the registry.
Would DR. GRACE ELLEN M SANTA TERESA (M.D.) appear as active to a payer?
You can treat DR. GRACE ELLEN M SANTA TERESA (M.D.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DR. GRACE ELLEN M SANTA TERESA (M.D.)?
DR. GRACE ELLEN M SANTA TERESA (M.D.) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DR. GRACE ELLEN M SANTA TERESA (M.D.) located near Brandon?
DR. GRACE ELLEN M SANTA TERESA (M.D.) currently maps to Brandon, Mississippi in this extract.
When was this NPI issued?
Enumeration for DR. GRACE ELLEN M SANTA TERESA (M.D.) is noted as June 29, 2007 where the registry provides it.

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