Look up the most recent NPI and PECOS records

Juan Sebastian Salazar

Internal Medicine

Allopathic & Osteopathic Physicians

4001 Coliseum Dr Ste 300, Hampton, VA 23666-6257

(757) 827-2025

PECOS Enrollment

This provider is enrolled in PECOS as JUAN SALAZAR.

Based on the most recent information from CMS, provider Juan Sebastian Salazar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1457849754
Provider Type
Individual
Full Name
Salazar, Juan Sebastian
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/23/2018
Last Updated
10/15/2024

Contact Information

Practice Location

4001 Coliseum Dr Ste 300, Hampton, VA 23666-6257

(757) 827-2025

(757) 275-9802

Mailing Location

4001 Coliseum Dr Ste 300, Hampton, VA 23666-6257

(757) 827-2025

(757) 275-9802

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 0101272292 Virginia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Juan Sebastian Salazar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Centerwell Senior Primary Care Va Pllc

Mccullen, Michael A

Benis, Yassine

Tidewater Internal Medicine Associates, P.C.

Johnson, Melvin Russell

Combs, Jason T

Brown, William Edward

Jackson, Pamela E

Mzhavanadze, Patman

Gallanosa, Anacleto Gamit