Andres Salazar

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

D0051051 Issued in MD

Practice address

3621 Ligon Rd
Ellicott City, MD 21042-5238

Phone

(410) 486-1500

NPI assigned

Dec 14, 2006

Last updated

Jul 26, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Pikesville Operator, LLC

  dba Autumn Lake Healthcare at Pikesville

  • Skilled Nursing Facility
  • Pikesville, MD
  • NPI 1811489511

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Post-Acute Care Center Opco LLC

  dba Autumn Lake Healthcare Post Acute Care Center

  • Skilled Nursing Facility
  • Baltimore, MD
  • NPI 1003386780

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Rossville SNF Operations LLC

  • Skilled Nursing Facility
  • Baltimore, MD
  • NPI 1528847860

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• SM Rehab

  • Skilled Nursing Facility
  • Boonsboro, MD
  • NPI 1750189627

  Adp of the SNF, Managing Control - Governing Body

  CMS ownership

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.

• Andres Salazar P a

  • Geriatric Medicine (Family Medicine) Physician
  • Ellicott City, MD
  • NPI 1811041528
  Medicare reassignment Authorized official
• Pikesville Operator, LLC

  dba Autumn Lake Healthcare at Pikesville

  • Skilled Nursing Facility
  • Pikesville, MD
  • NPI 1811489511
  NPD (past)
• Post Acute Health Care Services LLC

  • Acute Care Nurse Practitioner
  • Pikesville, MD
  • NPI 1982423653
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1265594493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 LIGON RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425238",
            "telephone_number": "410-750-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 LIGON RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425238",
            "telephone_number": "410-486-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0051051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692900100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Geriatric Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.