Active NPI
Mary Yassa Salib, MD
- Family Medicine Physician
- Cantonment, FL
National Provider Identifier
1528040409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME87968
- Practice address
- 749 N Highway 29
Cantonment, FL 32533-9596 - Phone
- (850) 937-4004
- Fax
- (850) 937-4006
- NPI assigned
- Nov 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME87968 | FL | Primary |
Addresses
Primary practice location
749 N Highway 29
Cantonment, FL 32533-9596
Mailing address
749 N Highway 29
Cantonment, FL 32533-9596
Phone (850) 937-4004
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44104 | Other | FL | BCBS FL |
| 270450100 | Medicaid | FL | |
| ME87968 | Other | FL | MEDICAL LICENSE NUMBER |
| 810657750 | Other | FL | CIGNA |
| K8350 | Other | FL | MEDICARE GROUP |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME87968 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cantonment Medical Center, LLC | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- marysalib@ecc.allscriptsdirect.net
Organizations & group practices 1
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": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1528040409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 N HIGHWAY 29",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325339596",
"telephone_number": "850-937-4004",
"fax_number": "850-937-4006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "749 N HIGHWAY 29",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325339596",
"telephone_number": "850-937-4004",
"fax_number": "850-937-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALIB",
"first_name": "MARY",
"middle_name": "YASSA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-16",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME87968",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "44104",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270450100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "ME87968",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "810657750",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "K8350",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cantonment, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.