Individual provider Active NPI

Maryann Salib, D.O.

  • Public Health & General Preventive Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1275978033
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
OS019463 Issued in PA
Practice address
861 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone
(215) 831-1100
NPI assigned
May 7, 2013
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1035329750002MedicaidPA
1035329750001MedicaidPA
1035329750003MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180927001015 PA Practitioner - Preventive Medicine 3173874351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS019463PAMDPublic 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

Verify at the official NPI Registry.