Individual provider Active NPI

Mauricio Salicru, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Dallas, TX
National Provider Identifier
1760732986
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
Q3788 Issued in TX
Practice address
3600 Gaston Ave
Widley Tower #261
Dallas, TX 75246-1800
Phone
(214) 820-3298
NPI assigned
Sep 14, 2012
Last updated
Sep 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Q3788 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Widley Tower #261
Dallas, TX 75246-1800

Mailing address

3600 Gaston Ave
Widley Tower #261
Dallas, TX 75246-1800
Phone (214) 820-3298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150804003795 TX Practitioner - Pathology 4183938210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at Houston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 947-8181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.85 of 100Reported as group
Quality
72.17
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q3788TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratory Physicians Association Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2018 Accepting new patients
Laboratory Physicians Association Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2018 Accepting new patients
Laboratory Physicians Association Anatomic Pathology & Clinical Pathology Current Accepting new patients
Pathologists Bio-Medical Laboratories PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

17101 Dallas Pkwy
Addison, TX 75001
Phone (214) 696-8033

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

8000 Eldorado Pkwy
McKinney, TX 75070
Phone (469) 424-6400

2831 George Bush Hwy
Richardson, TX 75082
Phone (469) 204-1000

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, 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": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1760732986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WIDLEY TOWER #261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-820-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WIDLEY TOWER #261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-820-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALICRU",
        "first_name": "MAURICIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "Q3788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.