Individual provider Active NPI

Mari Krisel Lantin Salazar, PA-C

  • Physician Assistant
  • Milton, MA
National Provider Identifier
1770944779
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110007749 Issued in VA
Practice address
199 Reedsdale Rd
Milton, MA 02186-3926
Phone
(617) 696-4600
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 0110007749 VA Primary

Addresses

Primary practice location

199 Reedsdale Rd
Milton, MA 02186-3926

Mailing address

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031-4400
Phone (703) 698-4444

Other practice location 1

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 698-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210720000420 VA Practitioner - Physician Assistant 3971906645 Reassigns benefits to 1 organization
I20210728002747 DC Practitioner - Physician Assistant 3971906645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfax Radiological ConsultantsGroup PAC ID 8628970324, 151 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 698-4444

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.5 of 100Reported as group
Quality
58.12
Improvement activities
40
Cost
68.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Radiological Consultants CurrentSince Jun 13, 2021 Accepting new patients

Locations

1800 N Beauregard St
Alexandria, VA 22311
Phone (703) 933-2590

400 Fannon St
Fl 1
Alexandria, VA 22301
Phone (571) 472-5400

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

22505 Landmark Ct
Ashburn, VA 20148
Phone (571) 472-6464

43490 Yukon Dr
Ste 204
Ashburn, VA 20147
Phone (571) 665-6960

2722 Merrilee Dr
Ste 230
Fairfax, VA 22031

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

8081 Innovation Park Dr
Bldg B
Fairfax, VA 22031
Phone 703698444414708

8505 Arlington Blvd
Ste 400
Fairfax, VA 22031
Phone (571) 226-5600

4315 Chain Bridge Rd
Fairfax, VA 22030
Phone (703) 205-9792

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

6355 Walker Ln
Franconia, VA 22310
Phone (703) 664-7453

13575 Heathcote Blvd
Ste 200
Gainesville, VA 20155
Phone (703) 468-2590

224 Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

9321 Sanger St
Lorton, VA 22079
Phone (703) 982-8324

11901 Baron Cameron Ave
Reston, VA 20190
Phone (703) 464-6480

Organizations & group practices 1

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 6

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1770944779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314400",
            "telephone_number": "703-698-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 REEDSDALE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863926",
            "telephone_number": "617-696-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-698-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "MARI KRISEL",
        "middle_name": "LANTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

Verify at the official NPI Registry.