Individual provider Active NPI

Eduardo Salcedo, M.D.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Odessa, TX
National Provider Identifier
1114955812
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
M7588 Issued in TX
Practice address
540 W 5TH St
Suite 300
Odessa, TX 79761-5034
Phone
(432) 640-3007
Fax
(432) 640-2708
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M7588 TX
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X M7588 TX Primary

Addresses

Primary practice location

540 W 5TH St
Suite 300
Odessa, TX 79761-5034

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-3007

Other practice location 1

500 W 4th St
Odessa, TX 79761-5001
Phone (432) 640-3007

Other identifiers 1

IdentifierTypeStateIssuer
183895502MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070226000289 TX Practitioner - Undersea and Hyperbaric MedicinePractitioner - DermatologyPractitioner - Family Practice 8820190614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Undersea and Hyperbaric MedicineAlso: Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional CareGroup PAC ID 1658358635, 51 clinicians

Practice addresses (Care Compare)

540 W 5TH St
Suite 300
Odessa, TX 79761-5035
Phone (432) 640-3007

Hospital & facility affiliations

  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Merit-based Incentive Payment System (MIPS)

Final score
79.78 of 100Reported as group
Quality
60.9
Promoting interoperability
100
Improvement activities
40
Cost
66.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue42
Removal of skin lesions289
Removal or shaving of skin growth1-10
Skin biopsy38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7588TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
Texas Tech University Health Sciences Center Odessa Family Medicine Past Accepting new patients

Locations

540 W 5th St
Ste 300
Odessa, TX 79761
Phone (432) 337-5411

315 Golder Ave
Odessa, TX 79761
Phone (432) 337-5411

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

315 Golder Ave
Ste B
Odessa, TX 79761
Phone (432) 332-2695

540 W 5th St
Ste 310
Odessa, TX 79761
Phone (432) 332-7500

6030 W University Blvd
Odessa, TX 79764
Phone (432) 640-6600

3001 John Ben Shepperd Pkwy
Odessa, TX 79762
Phone (432) 640-6700

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 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1114955812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-3007",
            "fax_number": "432-640-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST",
            "address_2": "SUITE 300",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615034",
            "telephone_number": "432-640-3007",
            "fax_number": "432-640-2708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797615001",
            "country_code": "US",
            "telephone_number": "432-640-3007",
            "fax_number": "432-640-2708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALCEDO",
        "first_name": "EDUARDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M7588",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "M7588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183895502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.