Individual provider Active NPI

Jacquelyn H Salas, MD

  • Emergency Medicine Physician
  • Truckee, CA
National Provider Identifier
1558572099
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G081548 Issued in CA
Practice address
10121 Pine Ave
Truckee, CA 96161
Phone
(530) 582-3220
Fax
(530) 271-1791
NPI assigned
May 25, 2007
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G081548 CA Primary

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161

Mailing address

Box 805
Nevada City, CA 95959
Phone (530) 271-1791

Other identifiers 1

IdentifierTypeStateIssuer
SR0090630MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20201211000392 NM Practitioner - Emergency Medicine 6507819372 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81548CAMDPharmacist
G081548CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Jan 4, 2021 Accepting new patients
Nes Arizona Inc Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Jul 17, 2023 Accepting new patients
Southside Hospital Past Accepting new patients
Mercy Hospital Springfield Past Accepting new patients
The Finley Hospital Emergency Medicine Past Accepting new patients
Covenant Medical Center Past Accepting new patients

Locations

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

900 W Ash St
Deming, NM 88030
Phone (505) 546-2761

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170

Interoperability endpoints

  • Direct secure messaging: jsalas559854@ahs.direct-ci.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1558572099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 805",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "95959",
            "telephone_number": "530-271-1791",
            "fax_number": "530-271-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "96161",
            "telephone_number": "530-582-3220",
            "fax_number": "530-271-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAS",
        "first_name": "JACQUELYN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G081548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SR0090630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.