Individual provider Active NPI

Mark Samir Salem

  • Gastroenterology Physician
  • Orange, CA
National Provider Identifier
1821356254
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A127236 Issued in CA
Practice address
101 The City Dr S Ste 400
Orange, CA 92868-3201
Phone
(714) 456-7358
NPI assigned
Apr 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A127236 CA Primary

Addresses

Primary practice location

101 The City Dr S Ste 400
Orange, CA 92868-3201

Mailing address

101 The City Dr S Ste 400
Orange, CA 92868-3201
Phone (714) 456-7358

Other practice location 1

1200 N State St
CT-A7D
Los Angeles, CA 90033-1029
Phone (323) 226-7556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191022003243 CA Practitioner - Gastroenterology 0547592651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Miami, LM Miller School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127236CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Gastroenterology CurrentSince Oct 1, 2019 Accepting new patients
UC Regents Current Accepting new patients
UC Regents CurrentSince Oct 1, 2019 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients
UC Regents Past Accepting new patients
The Regents of the University of California-Irvine PastSince Feb 9, 2020 Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 22
Orange, CA 92868
Phone (888) 717-4463

101 The City Dr S
Ste 400
Orange, CA 92868
Phone (714) 456-5691

101 The City Dr S
Bldg 22C
Orange, CA 92868
Phone (714) 456-5308

Organizations & group practices 7

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 2

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1821356254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S STE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S STE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "CT-A7D",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-226-7556",
            "fax_number": "323-226-2657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALEM",
        "first_name": "MARK",
        "middle_name": "SAMIR",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A127236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.