NPIMap

Individual provider Active NPI

Sedrick A. Salisbury, M.D.

  • Internal Medicine Physician
  • Lebanon, OR
National Provider Identifier
1174568638
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15516 Issued in OR
Practice address
325 Park St
Lebanon, OR 97355-4229
Phone
(541) 451-7200
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 MD15516 OR Primary

Addresses

Primary practice location

325 Park St
Lebanon, OR 97355-4229

Mailing address

PO Box 1193
Corvallis, OR 97339-1193

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsalisbury4153@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000438 OR Practitioner - Internal Medicine 4688669617 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

191 N Main St
Main Street Family Medicine
Lebanon, OR 97355-2870
Phone (541) 451-7940

325 Park St
Lebanon, OR 97355-4229
Phone (541) 451-7200

525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone (541) 258-2101

Hospital & facility affiliations

  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
88.09
Promoting interoperability
100
Improvement activities
40
Cost
84.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15516ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc CurrentSince Mar 20, 2020 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Mar 20, 2020 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Mar 20, 2020 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Jan 1, 2004 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Albany General Hospital Current Accepting new patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Mar 20, 2020 Accepting new patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Mar 20, 2020 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Jan 1, 2004 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Mar 20, 2020 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Internal Medicine PastSince Sep 1, 2004 Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

425 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6960

525 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 258-2101

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1174568638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1193",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554229",
            "telephone_number": "541-451-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALISBURY",
        "first_name": "SEDRICK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD15516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsalisbury4153@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "325 Park St",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.