Active NPI
Maryann Salib, D.O.
- Public Health & General Preventive Medicine Physician
- Philadelphia, PA
National Provider Identifier
1275978033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- OS019463
- Practice address
- 861 E Allegheny Ave
Philadelphia, PA 19134-2401 - Phone
- (215) 831-1100
- NPI assigned
- May 7, 2013
- Last updated
- Oct 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | OS019463 | PA | Primary |
Addresses
Primary practice location
861 E Allegheny Ave
Philadelphia, PA 19134-2401
Mailing address
4417 N 6TH St
Philadelphia, PA 19140-2319
Phone (215) 302-3600
Other practice location 1
4417 N 6th St
Philadelphia, PA 19140-2319
Phone (215) 302-3600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1035329750002 | Medicaid | PA | |
| 1035329750001 | Medicaid | PA | |
| 1035329750003 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180927001015 | PA | Practitioner - Preventive Medicine | 3173874351 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS019463 | PA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1275978033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4417 N 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191402319",
"telephone_number": "215-302-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 E ALLEGHENY AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191342401",
"telephone_number": "215-831-1100"
}
],
"practiceLocations": [
{
"address_1": "4417 N 6th St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191402319",
"country_code": "US",
"telephone_number": "215-302-3600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALIB",
"first_name": "MARYANN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-07",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "PA",
"license": "OS019463",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1035329750002",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1035329750001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1035329750003",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.