Individual provider Active NPI

Marc Salomon, MD

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1417481649
Registry record updated Oct 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
185936 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033-5313
Phone
(323) 442-8541
NPI assigned
Apr 13, 2017
Last updated
Oct 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 185936 CA Primary
Diagnostic Radiology Physician 2085R0202X 275357 MA

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Other practice location 1

910 Prince St
Teaneck, NJ 07666-4636
Phone (201) 675-8416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231006002549 CA Practitioner - Diagnostic Radiology 6305197054 Reassigns benefits to 1 organization
I20251124002919 NJ Practitioner - Diagnostic Radiology 6305197054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (800) 825-5391

5 Summer Hill Dr
Hamilton, NJ 08620-9515
Phone (800) 825-5391

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185936CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Main Street PC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 21, 2023 Accepting new patients
Valley Physician Services PC CurrentSince Sep 13, 2025 Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Aug 21, 2023 Accepting new patients
Usc Radiology Associates PastSince Oct 15, 2023 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697241600000",
    "number": "1417481649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Prince St",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076664636",
            "country_code": "US",
            "telephone_number": "201-675-8416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2023-10-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "185936",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "275357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.