NPIMap

Individual provider Active NPI

Maria D Salamatin, MD

  • Internal Medicine Physician
  • Bullhead City, AZ
National Provider Identifier
1013989409
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34106 Issued in AZ
Practice address
3003 Highway 95
Suite 101
Bullhead City, AZ 86442-7802
Phone
(928) 758-0202
Fax
(928) 758-2656
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34106 AZ Primary

Addresses

Primary practice location

3003 Highway 95
Suite 101
Bullhead City, AZ 86442-7802

Mailing address

3003 Highway 95
Suite 101
Bullhead City, AZ 86442-7802
Phone (928) 758-0202

Other identifiers 1

IdentifierTypeStateIssuer
985187MedicaidAZ

Other names 1

  • Maria Doris Abuyuan Sta.Agueda Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000185 AZ Practitioner - Internal Medicine 2264450261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2585 Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522

3003 Hwy 95
Suite 101
Bullhead City, AZ 86442-7802
Phone (928) 758-0202

Hospital & facility affiliations

  • Valley View Home Health Home health agency, Bullhead City, AZ, CCN 037412
  • Canyon Home Care & Hospice Home health agency, Gilbert, AZ, CCN 037418
  • River Valley Home Health Home health agency, Lake Havasu, AZ, CCN 037402
  • Arizona Life Hospice - Mohave Hospice, Fort Mohave, AZ, CCN 031723
  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101
  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34106AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Angels Medical Clinic PLC CurrentSince Oct 17, 2005 Accepting new patients
Cardiology Clinic of Muskogee, Inc. Internal Medicine Past Accepting new patients

Locations

3003 Highway 95
Ste 101
Bullhead City, AZ 86442
Phone (520) 758-9500

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCCDA/Endpoint/AGCCDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCCDA
  • FHIR API: https://api.platform.athenahealth.com/3442/brand/1/csg/61/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arizona Life Hospice - MohaveFort Mohave, AZ, CCN 031723 Hospice Contracted Managing Employee (100%)
Operational/Managerial Control (100%)		 Dec 1, 2021
Dec 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1013989409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 HIGHWAY 95",
            "address_2": "SUITE 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427802",
            "telephone_number": "928-758-0202",
            "fax_number": "928-758-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 HIGHWAY 95",
            "address_2": "SUITE 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427802",
            "telephone_number": "928-758-0202",
            "fax_number": "928-758-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMATIN",
        "first_name": "MARIA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "34106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "985187",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA DORIS",
            "last_name": "STA.AGUEDA",
            "middle_name": "ABUYUAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.