Individual provider Active NPI

Nelly N Salem, M.D.

  • Diagnostic Radiology Physician
  • Stanford, CA
National Provider Identifier
1366698284
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A119378 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305
Phone
(650) 723-4000
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301092760 MI
Diagnostic Radiology Physician 2085R0202X 35.121297 OH
Diagnostic Radiology Physician 2085R0202X A119378 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other identifiers 1

IdentifierTypeStateIssuer
0085025MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180626002303 CA Practitioner - Diagnostic Radiology 5395985709 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

8933 Activity Rd
San Diego, CA 92126-4427
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301092760MIMDInternal Medicine Physician
A119378CAMDDiagnostic Radiology Physician
35.121297OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Apr 26, 2021 Accepting new patients
San Diego Imaging-Chula Vista LLC CurrentSince Jul 27, 2020 Accepting new patients
Hanford Community Hospital CurrentSince Aug 19, 2020 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Internal Medicine CurrentSince Apr 26, 2021 Accepting new patients
Adventist Health Tulare CurrentSince Aug 19, 2020 Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

765 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 397-6577

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

125 Mall Dr
Ste 305
Hanford, CA 93230
Phone (559) 537-0440

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

8933 Activity Rd
San Diego, CA 92126
Phone (858) 499-2704

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

Interoperability endpoints

  • Direct secure messaging: nsalem114380@sharphealthcare.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/a36dfa71-4dd3-4608-9cfb-c7a63ade5531/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1366698284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEM",
        "first_name": "NELLY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092760",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.121297",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A119378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085025",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.