Individual provider Active NPI

Madeline Holm Salyer, PA-C

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1063273571
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009654 Issued in VA
Practice address
860 Omni Blvd Ste 113
Newport News, VA 23606-4430
Phone
(757) 327-0657
Fax
(757) 240-5096
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110009654 VA Primary

Addresses

Primary practice location

860 Omni Blvd Ste 113
Newport News, VA 23606-4430

Mailing address

860 Omni Blvd Ste 128
Newport News, VA 23606-4483
Phone (757) 504-0924

Other names 1

  • Ms. Madeline Elizabeth Holm Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000890 VA Practitioner - Physician Assistant 0143663567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

11751 Rock Landing Dr
Suite 1
Newport News, VA 23606-4233
Phone (757) 240-2700

2 Bernadine Dr
Newport News, VA 23602-4404
Phone (757) 886-6877

400 Sentara Cir
Suite 400
Williamsburg, VA 23188-5716
Phone (757) 645-3150

4125 Ironbound Rd
Suite 200
Williamsburg, VA 23188-2666
Phone (757) 345-2829

5424 Discovery Park Blvd
Williamsburg, VA 23188-2862

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

Hospital & facility affiliations

  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Feb 1, 2024 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

5659 Parkway Dr
Ste 200
Gloucester, VA 23061
Phone (757) 259-0443

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 113
Newport News, VA 23606
Phone (757) 327-0657

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

860 Omni Blvd
Ste 128
Newport News, VA 23606

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

Hospital & facility affiliations 4

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1063273571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 128",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064483",
            "telephone_number": "757-504-0924",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 113",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-327-0657",
            "fax_number": "757-240-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALYER",
        "first_name": "MADELINE",
        "middle_name": "HOLM",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "HOLM",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "PA-C, MMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.