Juan Carlos Salazar, M.D.
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Poplar Bluff, MO
NPI 1922041995 · NPPES record last updated Apr 11, 2024
Key facts
- NPI
- 1922041995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- 2000174358 (MO)
- Practice address
- 1140 Herschel Bess Blvd
Poplar Bluff, MO 63901-3075 - Phone
- (573) 686-1200
- Fax
- (573) 686-1029
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Compass Counseling Services, LLC
Practice addresses (Care Compare)
1400 N Semoran Blvd
Orlando, FL 32807-3536
Phone (407) 823-8421
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.41 of 100
- Quality
- 79.26
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090216000454 | MO | Practitioner - Psychiatry | 5395800932 | Reassigns benefits to 2 organizations |
| I20151228000645 | FL | Practitioner - Psychiatry | 5395800932 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME124792 | FL | MD | Psychiatry Physician |
| 2000174358 | MO | MD | Psychiatry Physician |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Counseling Services, LLC | Current |
Accepting new patients | |
| Bootheel Counseling Services | Current |
Accepting new patients | |
| Bootheel Counseling Services | Current |
Accepting new patients | |
| Poplar Bluff Hma Physician Management, LLC | Psychiatry | Current |
Accepting new patients |
| Compass Counseling Services,LLC | Past | Accepting new patients | |
| Bootheel Counseling Services | Past |
Accepting new patients |
Locations
1400 N Semoran Blvd
Orlando, FL 32807
Phone (407) 823-8421
1400 N Semoran Blvd
Ste E
Orlando, FL 32807
Phone (407) 823-8421
3098 Oak Grove Rd
Poplar Bluff, MO 63901
Phone (573) 778-2600
760 Plantation Blvd
Sikeston, MO 63801
Phone 5734710880245
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2000174358 | MO | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 2000174358 | MO | Yes |
Addresses
Primary practice location
1140 Herschel Bess Blvd
Poplar Bluff, MO 63901-3075
Mailing address
5716 Lake Shore Dr
Poplar Bluff, MO 63901-9648
Phone (573) 686-2127
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431116734 | Other | UNITED BEHAVIORAL HEALTH | |
| 205345804 | Medicaid | MO | |
| 461695 | Other | HEALTHLINK HMO | |
| 461695 | Other | HEALTHLINK PPO |
Other providers in Poplar Bluff, MO
- Saint Francis Medical Center
- Saint Francis Medical Center
- Saint Francis Medical Center
- Saint Francis Medical Center
- Faith Elisabeth Salamone
- Kiptoo Kipyator Sammin
- Dalton Sanders
- Sharon Sanders
- Zoe Marie Sanders
- Donna Sandlin
All providers in Poplar Bluff, MO · Child & Adolescent Psychiatry Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.