Mariam Salahou, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP008704 Issued in PA

Practice address

16 Old Ashton Rd
Suite 1
Phila, PA 19152-1661

Phone

(215) 613-5069

Fax

(215) 613-6809

NPI assigned

Jul 28, 2006

Last updated

May 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22343/brand/1/csg/1/fhir/r4
• Direct secure messaging: mariam.salahou.1@22343.direct.athenahealth.com

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.

• Fademos Family Practice

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1801138896
  Medicare reassignment NPD Authorized official
• Primary Homecare, LLC

  • Primary Care Nurse Practitioner
  • Elkins Park, PA
  • NPI 1629023593
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431734400000",
    "number": "1780698613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 OLD ASHTON RD",
            "address_2": "SUITE 1",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191521661",
            "telephone_number": "215-613-5069",
            "fax_number": "215-613-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 OLD ASHTON RD",
            "address_2": "SUITE 1",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191521661",
            "telephone_number": "215-613-5069",
            "fax_number": "215-613-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAHOU",
        "first_name": "MARIAM",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2848495000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLN",
            "identifier": "30013868",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1487927",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11585583",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO (ELDER) HEALTH",
            "identifier": "17574",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Ryan, CRNP
• Tierra Toni Ryan, PHARM.D
• S.G. Isaacs Enterprises, Inc.
• Polly Sacco Ezzell, RN
• Duri Sabina Saeed
• Salana, Inc. (Miracle Ear)
• Stacey Saleff, MOTR/L, RYT
• John Avery Salvia, PA
• Sami Khella MD PC
• Christian Santana, DDS

• Family Nurse Practitioner in Phila, PA
• Providers in Phila, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.