NPIMap

Individual provider Active NPI

Qazim Salia, PA

  • Family Medicine Physician
  • Melbourne, FL
National Provider Identifier
1972930717
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA9107628 Issued in FL
Practice address
1270 N Wickham Rd Ste 9
Melbourne, FL 32935-8300
Phone
(321) 567-2211
Fax
(321) 286-0496
NPI assigned
Oct 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Medicine Physician 207Q00000X PA9107628 FL Primary

Addresses

Primary practice location

1270 N Wickham Rd Ste 9
Melbourne, FL 32935-8300

Mailing address

1270 N Wickham Rd Ste 9
Melbourne, FL 32935-8300
Phone (321) 567-2211

Other identifiers 3

IdentifierTypeStateIssuer
7429010OtherFLCIGNA
009918200MedicaidFL
Y0KJ8OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, NY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20131114001388 FL Practitioner - Physician Assistant 5496981789 Reassigns benefits to 5 organizations
I20150601002313 TX Practitioner - Physician Assistant 5496981789 Reassigns benefits to 1 organization
I20201121000019 NY Practitioner - Physician Assistant 5496981789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1270 N Wickham Rd
Suite 9
Melbourne, FL 32935-8300
Phone (321) 567-2211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 24, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 24, 2020 Accepting new patients
Nahed S. Sobhy M.D. P.a. Current Accepting new patients
Medec Urgent Care PLLC CurrentSince Nov 1, 2021 Accepting new patients
Ipn Emergency Physicians of North Florida PA Physician Assistant Past Accepting new patients
Southland Optim Jenkins Emergency Medical Services, LLC Past Accepting new patients

Locations

600 Garden St
Titusville, FL 32796
Phone (321) 567-2211

Interoperability endpoints

  • Direct secure messaging: qazim.salia.1@31815.direct.athenahealth.com

Organizations & group practices 12

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 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": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1972930717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 N WICKHAM RD STE 9",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358300",
            "telephone_number": "321-567-2211",
            "fax_number": "321-286-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 N WICKHAM RD STE 9",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358300",
            "telephone_number": "321-567-2211",
            "fax_number": "321-286-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIA",
        "first_name": "QAZIM",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-10",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9107628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7429010",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009918200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0KJ8",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.