Individual provider Active NPI

Edi Lor San Pedro Salomon

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1922643873
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3225 Westchester Ave
Bronx, NY 10461-4507
Phone
(718) 409-0050
NPI assigned
Nov 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3225 Westchester Ave
Bronx, NY 10461-4507

Mailing address

3225 Westchester Ave
Bronx, NY 10461-4507
Phone (718) 409-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203002270 NY Practitioner - Physical Therapist in Private Practice 6406386697 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Jan 10, 2025 Accepting new patients

Locations

4487 3rd Ave
Fl 7
Bronx, NY 10457
Phone (718) 960-6173

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: edilor.salomon.1@18107.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1922643873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614507",
            "telephone_number": "718-409-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614507",
            "telephone_number": "718-409-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "EDI LOR",
        "middle_name": "SAN PEDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-14",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; 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.