Individual provider Active NPI

Skyler Marie Salmasi, NP-C

  • Primary Care Nurse Practitioner
  • La Marque, TX
National Provider Identifier
1104089630
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
666806 Issued in TX
Practice address
2600 FM 1764 Rd
Suite 190
La Marque, TX 77568-2824
Phone
(281) 886-8964
Fax
(409) 440-8071
NPI assigned
Jul 3, 2008
Last updated
Jun 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 666806 TX Primary

Addresses

Primary practice location

2600 FM 1764 Rd
Suite 190
La Marque, TX 77568-2824

Mailing address

2600 FM 1764 Rd
Ste 190
La Marque, TX 77568-2826
Phone (281) 886-8964

Other identifiers 1

IdentifierTypeStateIssuer
00220ZOtherTXMEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20081120000463 TX Practitioner - Nurse Practitioner 6800956889 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
666806TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1104089630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 FM 1764 RD",
            "address_2": "STE 190",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775682826",
            "telephone_number": "281-886-8964",
            "fax_number": "409-440-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FM 1764 RD",
            "address_2": "SUITE 190",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775682824",
            "telephone_number": "281-886-8964",
            "fax_number": "409-440-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMASI",
        "first_name": "SKYLER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "666806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "00220Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Marque, TX

Sources for this page

Verify at the official NPI Registry.