NPIMap

Individual provider Active NPI

Aaron I Salomon, PAC

  • Physician Assistant
  • Gothenburg, NE
National Provider Identifier
1689736019
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
876 Issued in NE
Practice address
918 20TH Street
Gothenburg, NE 69138-1237
Phone
(308) 537-7131
Fax
(308) 537-7310
NPI assigned
Dec 14, 2006
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 876NE NE
Physician Assistant 363A00000X 876 NE Primary

Addresses

Primary practice location

918 20TH Street
Gothenburg, NE 69138-1237

Mailing address

918 20TH Street
Gothenburg, NE 69138-1237
Phone (308) 537-7131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000628 NE Practitioner - Physician Assistant 0749294783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gothenburg Memorial HospitalGroup PAC ID 6709832983, 12 clinicians

Practice addresses (Care Compare)

910 20TH St
Gothenburg, NE 69138-1237
Phone (308) 537-3661

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
876NENEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gothenburg Memorial Hospital CurrentSince Nov 10, 2014 Accepting new patients
K C Health Care Enterprises Inc Past Accepting new patients
Gothenburg Memorial Hospital Past Accepting new patients
Craig D Bartruff M.D., P.C. Past Accepting new patients
Horizons West Medical Group a Professional Corportion Past Accepting new patients

Locations

910 20th St
Gothenburg, NE 69138
Phone (308) 537-3661

918 20th St
Gothenburg, NE 69138
Phone (308) 537-4066

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 8

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1689736019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 20TH STREET",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381237",
            "telephone_number": "308-537-7131",
            "fax_number": "308-537-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 20TH STREET",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381237",
            "telephone_number": "308-537-7131",
            "fax_number": "308-537-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "AARON",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "876NE",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gothenburg, NE

Sources for this page

Verify at the official NPI Registry.