Individual provider Active NPI

Brandon Salgado, M.D.

  • Pediatrics Physician
  • Mansfield, LA
National Provider Identifier
1710243340
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q4271 Issued in TX
Practice address
130 Jefferson St
Mansfield, LA 71052-2602
Phone
(318) 872-2700
Fax
(318) 872-6214
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 307846 LA
Pediatrics Physician 208000000X Q4271 TX Primary

Addresses

Primary practice location

130 Jefferson St
Mansfield, LA 71052-2602

Mailing address

130 Jefferson St
Mansfield, LA 71052-2602
Phone (318) 872-2700

Other identifiers 1

IdentifierTypeStateIssuer
2189131MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandon.salgado@drfmc.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20180907001543 LA Practitioner - Pediatric Medicine 8820301898 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307846LAMDPediatrics Physician
Q4271TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Hospital Association Multi-Specialty CurrentSince Oct 1, 2018 Accepting new patients
Desoto Hospital Association Multi-Specialty Current Accepting new patients
Desoto Hospital Association CurrentSince Oct 1, 2018 Accepting new patients
Desoto Regional Family Medicine Multi-Specialty CurrentSince Oct 1, 2018 Accepting new patients
Desoto Hospital Association CurrentSince Oct 1, 2018 Accepting new patients

Locations

130 Jefferson St
Mansfield, LA 71052
Phone (318) 872-2700

207 Jefferson St
Mansfield, LA 71052
Phone (318) 871-3109

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEDHAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1710243340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522602",
            "telephone_number": "318-872-2700",
            "fax_number": "318-872-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522602",
            "telephone_number": "318-872-2700",
            "fax_number": "318-872-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALGADO",
        "first_name": "BRANDON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "307846",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q4271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2189131",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandon.salgado@drfmc.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 Jefferson St",
            "city": "Mansfield",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710522602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, LA

Sources for this page

Verify at the official NPI Registry.