Andres Salazar P a

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

D0051051 Issued in MD

Legal business name

ANDRES SALAZAR P A

Practice address

3621 Ligon Rd
Ellicott City, MD 21042-5238

Phone

(410) 530-0454

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Andres Salazar, MDNPI 1265594493

Title

President

Phone

(410) 530-0454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andres Salazar

  • Geriatric Medicine (Family Medicine) Physician
  • Ellicott City, MD
  • NPI 1265594493
  Medicare reassignment Authorized official
• Kumli Anye

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1104221613
  Medicare reassignment

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811041528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 LIGON RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425238",
            "telephone_number": "410-530-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 LIGON RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425238",
            "telephone_number": "410-530-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRES SALAZAR P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-530-0454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0051051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Lea Anderson, OTD, OTR/L
• Ellen Anderson, DPT
• Joshua Alan Anderson, MS, PA-C
• Mary Katherine Anderson, DDS
• Tammy Anderson, LPN
• Zoe Marie Andrews, RDN
• Anesthesia Company, LLC
• Vijayalakshmi Natarajan Angamuthu, DDS
• Tricia K Angulo-Bartlett, CRNP
• Virginia Anikwata, LPN

• Geriatric Medicine (Family Medicine) Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Geriatric Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.