Individual provider Active NPI

Waddah Salman, MD

  • Interventional Cardiology Physician
  • Jacksonville, FL
National Provider Identifier
1568441012
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME98532 Issued in FL
Practice address
6444 Beach Blvd
Jacksonville, FL 32216-2891
Phone
(904) 805-9600
Fax
(904) 805-0084
NPI assigned
Jan 12, 2006
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME98532 FL Primary

Addresses

Primary practice location

6444 Beach Blvd
Jacksonville, FL 32216-2891

Mailing address

6444 Beach Blvd
Jacksonville, FL 32216-2891
Phone (904) 805-9600

Other identifiers 1

IdentifierTypeStateIssuer
4457540MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070919000623 FL Practitioner - Cardiovascular Disease (Cardiology) 7012011331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Cardiovascular Center PLGroup PAC ID 4284612730, 3 clinicians

Practice addresses (Care Compare)

4131 University Blvd S
Suite 17
Jacksonville, FL 32216-4346
Phone (904) 805-9600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME98532FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Cardiovascular Center PL CurrentSince Jul 1, 2007 Accepting new patients
Premier Medical Care P C Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

4131 University Blvd S
Ste 17
Jacksonville, FL 32216
Phone (904) 722-1515

6444 Beach Blvd
Jacksonville, FL 32216
Phone (904) 580-8126

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1568441012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162891",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162891",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMAN",
        "first_name": "WADDAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME98532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4457540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.