Individual provider Active NPI

Daniel Thomas Matthew Salter, F.N.P.

  • Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1396053575
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201805314NP-PP Issued in OR
Practice address
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone
(503) 666-5050
Fax
(503) 666-1162
NPI assigned
Sep 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201805314NP-PP OR
Family Nurse Practitioner 363LF0000X 9267450 FL
Nurse Practitioner 363L00000X 201805314NP-PP OR Primary

Addresses

Primary practice location

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900

Other practice location 1

205 SE Spokane St Ste 300
Portland, OR 97202-6487
Phone (503) 714-8987

Other practice location 2

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170913001823 AL Practitioner - Nurse Practitioner 4385928225 Reassigns benefits to 1 organization
I20190318000692 OR Practitioner - Nurse Practitioner 4385928225 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201805314NP-PPORMDNurse Practitioner
9267450FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth-Oregon PC CurrentSince Dec 4, 2019 Accepting new patients
Legacy Clinics LLC CurrentSince Jan 8, 2019 Accepting new patients
Mobile Emergency Physicians, LLC CurrentSince May 15, 2017 Accepting new patients

Locations

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

2850 SE Powell Valley Rd
Gresham, OR 97080
Phone (503) 666-5050

205 SE Spokane St
Ste 300
Portland, OR 97202
Phone (503) 388-4255

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: daniel.salter@450368864321540.direct.elationemr.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1396053575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 SE Spokane St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972026487",
            "country_code": "US",
            "telephone_number": "503-714-8987",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALTER",
        "first_name": "DANIEL",
        "middle_name": "THOMAS MATTHEW",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-21",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201805314NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9267450",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201805314NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.