Individual provider Active NPI

Rafael Salas Martinez, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1396754321
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A72865 Issued in CA
Practice address
3699 Wilshire Blvd
3Rd Floor
Los Angeles, CA 90010-2718
Phone
(323) 783-7338
Fax
(323) 783-4120
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A72865 CA Primary

Addresses

Primary practice location

3699 Wilshire Blvd
3Rd Floor
Los Angeles, CA 90010-2718

Mailing address

3699 Wilshire Blvd
3Rd Floor
Los Angeles, CA 90010-2718
Phone (323) 783-7338

Other names 1

  • Dr. Rafael Salas Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20040323002035 CA Practitioner - Hospice/Palliative CarePractitioner - Geriatric MedicinePractitioner - Internal Medicine 9234020678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Geriatric Medicine
Education
University of California, Geffen School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

4900 W Sunset Blvd
Los Angeles, CA 90027-5814
Phone (323) 783-4011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72865CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 10, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 10, 2010 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1396754321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 WILSHIRE BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102718",
            "telephone_number": "323-783-7338",
            "fax_number": "323-783-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 WILSHIRE BLVD",
            "address_2": "3RD FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102718",
            "telephone_number": "323-783-7338",
            "fax_number": "323-783-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAS MARTINEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A72865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RAFAEL",
            "last_name": "SALAS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.