Individual provider Active NPI

Ili Salama

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1235254137
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213134 Issued in NY
Practice address
1343 E 14TH St
Brooklyn
Brooklyn, NY 11230-5901
Phone
(718) 221-7232
Fax
(718) 221-7272
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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 213134 NY Primary

Addresses

Primary practice location

1343 E 14TH St
Brooklyn
Brooklyn, NY 11230-5901

Mailing address

2402 28TH St
Astoria, NY 11102-1904

Other identifiers 1

IdentifierTypeStateIssuer
213134MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213134NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1235254137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 28TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 E 14TH ST",
            "address_2": "BROOKLYN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305901",
            "telephone_number": "718-221-7232",
            "fax_number": "718-221-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMA",
        "first_name": "ILI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "213134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213134",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.