Individual provider Active NPI

Rod Guerrero Salgado, PHD

  • Intellectual & Developmental Disabilities Psychologist
  • Baltimore, MD
National Provider Identifier
1053929372
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
PSY200001357 Issued in DC
Practice address
140 N Luzerne Ave
Baltimore, MD 21224-1147
Phone
(262) 902-4830
NPI assigned
Jul 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 06714 MD
Student in an Organized Health Care Education/Training Program 390200000X
Intellectual & Developmental Disabilities Psychologist 103TM1800X PSY200001357 DC Primary

Addresses

Primary practice location

140 N Luzerne Ave
Baltimore, MD 21224-1147

Mailing address

140 N Luzerne Ave
Baltimore, MD 21224-1147
Phone (262) 902-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221104002036 DC Practitioner - Clinical Psychologist 8224405170 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06714MDMDClinical Child & Adolescent Psychologist
PSY200001357DCMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Oct 10, 2022 Accepting new patients
Children'S Hospital CurrentSince Oct 10, 2022 Accepting new patients
Children'S Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

15245 Shady Grove Rd
Ste 350
Rockville, MD 20850
Phone (202) 476-5506

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.

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1053929372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N LUZERNE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241147",
            "telephone_number": "262-902-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N LUZERNE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241147",
            "telephone_number": "262-902-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALGADO",
        "first_name": "ROD",
        "middle_name": "GUERRERO",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "06714",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "DC",
            "license": "PSY200001357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.