Individual provider Active NPI

David Salm, MD

  • Internal Medicine Physician
  • Mystic, CT
National Provider Identifier
1184727273
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
028479 Issued in CT
Practice address
11 Main St Ste 11-205
Mystic, CT 06355-3654
Phone
(860) 421-1090
Fax
(860) 421-1091
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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 028479 CT Primary

Addresses

Primary practice location

11 Main St Ste 11-205
Mystic, CT 06355-3654

Mailing address

11 Main St Ste 11-205
Mystic, CT 06355-3654
Phone (860) 421-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20091223000365 CT Practitioner - Internal Medicine 5890835888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Value in Prevention of Connecticut PLLCGroup PAC ID 9335680362, 2 clinicians

Practice addresses (Care Compare)

11 Main St
Suite 11 205
Mystic, CT 06355-3654
Phone (860) 421-1090

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Southeast Home health agency, Waterford, CT, CCN 077015
  • Masonicare Home Health & Hospice, Inc Home health agency, Wallingford, CT, CCN 077159
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028479CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Internal Medicine CurrentSince Jun 1, 1997 Accepting new patients
Value in Prevention of Connecticut PLLC Internal Medicine CurrentSince Aug 30, 2024 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

4 Farm Springs Rd
Farmington, CT 06032
Phone (860) 284-5200

55 Nye Rd
Glastonbury, CT 06033
Phone (860) 430-1132

11 Main St
Ste 11205
Mystic, CT 06355
Phone (860) 421-1090

11 Main St
Ste 11
Mystic, CT 06355

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

4950 Communication Ave
Ste 100
Boca Raton, FL 33431
Phone (561) 982-4300

Interoperability endpoints

  • Direct secure messaging: david.salm.npi1184727273.phpct@direct.optumcare.masshiway.net
  • Direct secure messaging: david.salm.1@31695.direct.athenahealth.com

Organizations & group practices 2

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 7

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1184727273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MAIN ST STE 11-205",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553654",
            "telephone_number": "860-421-1090",
            "fax_number": "860-421-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAIN ST STE 11-205",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553654",
            "telephone_number": "860-421-1090",
            "fax_number": "860-421-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALM",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "028479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.