Individual provider Active NPI

Jeffrey P Salomone, MD

  • Surgical Critical Care Physician
  • Mesa, AZ
National Provider Identifier
1093897506
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
47058 Issued in AZ
Practice address
2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone
(480) 969-4138
Fax
(480) 969-0630
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 47058 AZ
Trauma Surgery Physician 2086S0127X 47058 AZ
Surgical Critical Care Physician 2086S0102X 47058 AZ Primary

Addresses

Primary practice location

2945 S Dobson Rd
Mesa, AZ 85202-7941

Mailing address

1450 S Dobson Rd Ste A200
Mesa, AZ 85202-4742
Phone (480) 629-5167

Other identifiers 1

IdentifierTypeStateIssuer
349220MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121228000075 AZ Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 8325291206 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Advanced Surgery LLC Surgery CurrentSince Apr 1, 2020 Accepting new patients

Locations

1450 S Dobson Rd
Ste A200
Mesa, AZ 85202
Phone (480) 629-5167

2945 S Dobson Rd
Mesa, AZ 85202
Phone (480) 699-2508

2320 N 3rd St
Phoenix, AZ 85004
Phone (602) 258-3262

Interoperability endpoints

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

Organizations & group practices 1

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1093897506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD STE A200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024742",
            "telephone_number": "480-629-5167",
            "fax_number": "480-912-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027941",
            "telephone_number": "480-969-4138",
            "fax_number": "480-969-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMONE",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "47058",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "47058",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AZ",
            "license": "47058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.