Individual provider Active NPI

Ann Kelley Salahuddin

  • Hematology & Oncology Physician
  • Ventura, CA
National Provider Identifier
1053350231
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G58702 Issued in CA
Practice address
168 N Brent St Ste 302
Ventura, CA 93003-2840
Phone
(805) 652-6373
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G58702 CA Primary

Addresses

Primary practice location

168 N Brent St Ste 302
Ventura, CA 93003-2840

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Other identifiers 3

IdentifierTypeStateIssuer
00G587020MedicaidCA
5628497OtherCANCPDP/NPDS
830001988OtherRAILROAD MEDICARE

Other names 1

  • Dr. Ann Schrader Kelley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100804000398 CA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 9032242813 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMK Medical Group, Inc. Hematology & Oncology CurrentSince Jan 1, 1995 Accepting new patients
Community Memorial Health System Current Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2460 N Ponderosa Dr
Ste A101
Camarillo, CA 93010
Phone (805) 482-1136

1700 N Rose Ave
Ste 320
Oxnard, CA 93030
Phone (805) 485-8709

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

168 N Brent St
Ste 302
Ventura, CA 93003
Phone (805) 652-6373

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Interoperability endpoints

  • Direct secure messaging: annschraderkelley@cmhealthsys.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1053350231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST STE 302",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032840",
            "telephone_number": "805-652-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAHUDDIN",
        "first_name": "ANN",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G58702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G587020",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP/NPDS",
            "identifier": "5628497",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830001988",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "KELLEY",
            "middle_name": "SCHRADER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.