Individual provider Active NPI

Ihor Salo, M.D.

  • Hospitalist Physician
  • Hoboken, NJ
National Provider Identifier
1912132408
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA08841700 Issued in NJ
Practice address
308 Willow Ave
Hoboken, NJ 07030-3808
Phone
(646) 402-4496
NPI assigned
May 27, 2009
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 254316 NY
Hospitalist Physician 208M00000X 25MA08841700 NJ Primary

Addresses

Primary practice location

308 Willow Ave
Hoboken, NJ 07030-3808

Mailing address

1100 Grand St Apt 302
Hoboken, NJ 07030-2235
Phone (646) 402-4496

Other identifiers 1

IdentifierTypeStateIssuer
0249122MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20120203000752 CA Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Geriatric Medicine 5597952390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Geriatric Medicine, Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

20940 Burbank Blvd
Woodland Hills, CA 91367-6601
Phone (888) 515-3500

322 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-5804
Phone (888) 515-3500

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254316NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 5, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 5, 2011 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 5

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 1

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1912132408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GRAND ST APT 302",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302235",
            "telephone_number": "646-402-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 WILLOW AVE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303808",
            "telephone_number": "646-402-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALO",
        "first_name": "IHOR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "254316",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA08841700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249122",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.