Individual provider Active NPI

Mary Susanna Salter, MD

  • Internal Medicine Physician
  • Bemidji, MN
National Provider Identifier
1093821621
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36411 Issued in MN
Practice address
514 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone
(218) 766-9281
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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 36411 MN Primary

Addresses

Primary practice location

514 Beltrami Ave NW
Bemidji, MN 56601-3010

Mailing address

PO Box 1155
Bemidji, MN 56619-1155
Phone (218) 766-9281

Other identifiers 1

IdentifierTypeStateIssuer
57G72SAOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101005000812 TX Practitioner - Internal Medicine 7113119421 Reassigns benefits to 1 organization
I20151013001684 MN Practitioner - Internal Medicine 7113119421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

514 Beltrami Ave NW
Bemidji, MN 56601-3010

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Care PA Current Accepting new patients
Department of Health & Human Services PHS IHS CurrentSince Jul 1, 2001 Accepting new patients
Mary S. Salter, MD PSC Internal Medicine CurrentSince Sep 18, 2015 Accepting new patients

Locations

350 E Devon Ave
Itasca, IL 60143

514 Beltrami Ave NW
#102
Bemidji, MN 56601
Phone (218) 308-0294

425 7th St NW
Cass Lake, MN 56633
Phone (218) 335-3200

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 3

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1093821621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1155",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566191155",
            "telephone_number": "218-766-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 BELTRAMI AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013010",
            "telephone_number": "218-766-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALTER",
        "first_name": "MARY",
        "middle_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "36411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57G72SA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.