Organization Active NPI

Thomas G. Salvi, MD, LLC

  • Primary Care Clinic/Center
  • Algonquin, IL
National Provider Identifier
1275031130
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036085984 Issued in IL
Legal business name
THOMAS G. SALVI, MD, LLC
Practice address
1106 N Main St
Algonquin, IL 60102-3482
Phone
(815) 353-2601
NPI assigned
Jan 25, 2018
Last updated
Jan 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Thomas G. Salvi, MDNPI 1902899461
Title
Physician Owner
Phone
(224) 333-0928

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036085984 IL Primary

Addresses

Primary practice location

1106 N Main St
Algonquin, IL 60102-3482

Mailing address

1106 N Main St
Algonquin, IL 60102-3482
Phone (224) 333-0928

Other identifiers 2

IdentifierTypeStateIssuer
036085984MedicaidIL
336.048074OtherILCONTROLLED SUBSTANCE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180208000157 IL Part B Supplier - Clinic/Group Practice 6103186382 Receives reassigned benefits from 3 practitioners
Practice locations: Algonquin, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2142421Thomas G Salvi, MD, LLC1106 N Main St, Algonquin, IL 60102Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory

Locations

1106 N Main St
Algonquin, IL 60102
Phone (224) 333-0928

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17421/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1275031130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N MAIN ST",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601023482",
            "telephone_number": "224-333-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N MAIN ST",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601023482",
            "telephone_number": "815-353-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G. SALVI, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "SALVI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "224-333-0928",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036085984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085984",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE NUMBER",
            "identifier": "336.048074",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.