Individual provider Active NPI

Salam Rafique, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Glendale, AZ
National Provider Identifier
1700819166
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2023001989 Issued in MO
Practice address
18701 N 67TH Ave
Glendale, AZ 85308-7100
Phone
(602) 978-6100
Fax
(602) 978-2446
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2023001989 MO Primary

Addresses

Primary practice location

18701 N 67TH Ave
Glendale, AZ 85308-7100

Mailing address

372 Gateshead Dr
Manchester, MO 63011-4331
Phone (602) 722-2074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230515000211 MO Practitioner - Critical Care (Intensivists) 1759574619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Cogent Healthcare of Missouri, Inc Critical Care Medicine CurrentSince Mar 1, 2023 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2024 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: srafique446752@direct-ehr-ssmhc.com
  • Direct secure messaging: salam.rafique.p1@direct.appss.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1700819166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 GATESHEAD DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114331",
            "telephone_number": "602-722-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18701 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087100",
            "telephone_number": "602-978-6100",
            "fax_number": "602-978-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFIQUE",
        "first_name": "SALAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2023001989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.