Individual provider Active NPI

Chelsea Tiffany Salas-Tam

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003435884
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD480194 Issued in PA
Practice address
2940 N 5TH St
Philadelphia, PA 19133-2801
Phone
(215) 302-3600
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD480194 PA
Family Medicine Physician 207Q00000X MD480194 PA Primary

Addresses

Primary practice location

2940 N 5TH St
Philadelphia, PA 19133-2801

Mailing address

4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 1

4417 N 6th St
Philadelphia, PA 19140-2319
Phone (215) 302-3600

Other practice location 2

861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 302-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000633 PA Practitioner - Family Practice 6204267438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Drexel University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health Center, Inc.Group PAC ID 6103815071, 32 clinicians

Practice addresses (Care Compare)

2940 N 5TH St
Philadelphia, PA 19133-2801
Phone (215) 302-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD480194PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Center, Inc. CurrentSince Aug 27, 2024 Accepting new patients
Esperanza Health Center, Inc. Past Accepting new patients

Locations

4417 N 6th St
Philadelphia, PA 19140
Phone (215) 302-3150

861 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 302-3600

2940 N 5th St
Philadelphia, PA 19133
Phone (215) 221-6633

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1003435884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 N 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402319",
            "telephone_number": "215-302-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332801",
            "telephone_number": "215-302-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4417 N 6th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191402319",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "861 E Allegheny Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191342401",
            "country_code": "US",
            "telephone_number": "215-302-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAS-TAM",
        "first_name": "CHELSEA",
        "middle_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD480194",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD480194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.