Individual provider Active NPI

Rafael Eduardo Salazar II, OTR/L

  • Occupational Therapist
  • Augusta, GA
National Provider Identifier
1164855425
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT005570 Issued in GA
Practice address
950 15TH St
Augusta, GA 30901-2608
Phone
(706) 733-0188
NPI assigned
Aug 9, 2013
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005570 GA Primary

Addresses

Primary practice location

950 15TH St
Augusta, GA 30901-2608

Mailing address

2320 Neal St
Augusta, GA 30906-3082
Phone (706) 829-6706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180626001537 GA Practitioner - Occupational Therapist in Private Practice 7911252358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Rehabilitation and Wellness LLCGroup PAC ID 7517387095, 8 clinicians

Practice addresses (Care Compare)

2103 Reedale Ave
Augusta, GA 30906-3430
Phone (706) 814-6887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT005570GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maguire Therapy Services Inc. CurrentSince Oct 16, 2017 Accepting new patients
Proactive Rehabilitation & Wellness LLC Physical Medicine & Rehabilitation CurrentSince Aug 31, 2020 Accepting new patients
Proactive Physical Therapy and Rehabilitation LLC CurrentSince Aug 31, 2020 Accepting new patients
Community Access & Inclusion Foundation Inc PastSince Jun 14, 2020 Accepting new patients

Locations

106 Pleasant Home Rd
Ste 2K
Augusta, GA 30907
Phone (706) 724-6543

2103 Reedale Ave
Augusta, GA 30906
Phone (706) 414-5058

Organizations & group practices 4

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1164855425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 NEAL ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063082",
            "telephone_number": "706-829-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012608",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "RAFAEL",
        "middle_name": "EDUARDO",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.