Individual provider Active NPI

Jakob R Salom, CNMT, RT (N)

  • Nuclear Medicine Technology Radiologic Technologist
  • San Juan, PR
National Provider Identifier
1407093776
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine Technology Radiologic TechnologistTaxonomy code 2471N0900X
License
CRT72895 Issued in FL
Practice address
1409 Ave Ashford
San Juan, PR 00907-1435
Phone
(787) 721-7979
NPI assigned
Jan 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Technology Radiologic Technologist 2471N0900X CRT72895 FL Primary
Nuclear Medicine Technology Radiologic Technologist 2471N0900X 0892 PR

Addresses

Primary practice location

1409 Ave Ashford
San Juan, PR 00907-1435

Mailing address

1303 Ave Magdalena Apt 803
San Juan, PR 00907-1917
Phone (787) 217-5141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CRT72895FLMDNuclear Medicine Technology Radiologic Technologist
0892PRMDNuclear Medicine Technology Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Tomografico de PR Inc Past Accepting new patients
Molecular Imaging PSC Past Accepting new patients

Organizations & group practices 2

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": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1407093776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 AVE MAGDALENA APT 803",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071917",
            "telephone_number": "787-217-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 AVE ASHFORD",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071435",
            "telephone_number": "787-721-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOM",
        "first_name": "JAKOB",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "CNMT, RT (N)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "FL",
            "license": "CRT72895",
            "primary": true
        },
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "PR",
            "license": "0892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.