Individual provider Active NPI

Miguel Antonio Salomon, MD

  • Family Medicine Physician
  • Carlisle, PA
National Provider Identifier
1952736225
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD039585E Issued in PA
Practice address
1533 Commerce Avenue
Suite 1
Carlisle, PA 17015
Phone
(717) 240-1322
Fax
(717) 240-0382
NPI assigned
Sep 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD039585E PA Primary

Addresses

Primary practice location

1533 Commerce Avenue
Suite 1
Carlisle, PA 17015

Mailing address

1533 Commerce Avenue
Suite 1
Carlisle, PA 17015
Phone (717) 240-1322

Other identifiers 1

IdentifierTypeStateIssuer
0010969640016MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140501001050 PA Practitioner - Family Practice 4082847876 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039585EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Department of Human Services CurrentSince Jul 13, 2017 Accepting new patients
Pennsylvania Department of Public Welfare CurrentSince Jul 13, 2017 Accepting new patients

Locations

50 Kirkbride Dr
Danville, PA 17821
Phone (570) 271-4542

827 Oley Valley Rd
White Haven, PA 18661
Phone (570) 443-4200

Organizations & group practices 2

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1952736225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 COMMERCE AVENUE",
            "address_2": "SUITE 1",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "17015",
            "telephone_number": "717-240-1322",
            "fax_number": "717-240-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 COMMERCE AVENUE",
            "address_2": "SUITE 1",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "17015",
            "telephone_number": "717-240-1322",
            "fax_number": "717-240-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "MIGUEL",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD039585E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010969640016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

Verify at the official NPI Registry.