PACIFIC COAST CLINIC SALEM LLC
NPI 1669704805
Clinic/Center - Adult Mental Health in Salem, OR

NPI Status: Active since February 11, 2010

Contact Information

1249 FAIRVIEW AVE SE
SALEM, OR
ZIP 97302
Phone: (971) 239-1146
Fax: (503) 907-9933

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  • Organization
  • Clinic/Center
  • Adult Mental Health

About PACIFIC COAST CLINIC SALEM LLC

This page provides the complete NPI Profile along with additional information for Pacific Coast Clinic Salem Llc, a provider established in Salem, Oregon operating as a Clinic/center, focusing in adult mental health . The healthcare provider is registered in the NPI registry with number 1669704805 assigned on February 2010. The practitioner's primary taxonomy code is 261QM0850X with license number MD24295 (OR). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Dr. Erum Ayaz Khaleeq Md (Psychiatrist)

NPI
1669704805
Provider Name
PACIFIC COAST CLINIC SALEM LLC
Entity Type
Organization
Location Address
1249 FAIRVIEW AVE SE SALEM, OR 97302
Location Phone
(971) 239-1146
Location Fax
(503) 907-9933
Mailing Address
1249 FAIRVIEW AVE SE SALEM, OR 97302
Mailing Phone
(971) 239-1146
Mailing Fax
(503) 907-9933
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-11-2010
Last Update Date
06-01-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adult Mental Health

Taxonomy Code
261QM0850X
Type
Ambulatory Health Care Facilities
License No.
MD24295
License State
OR
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ERUM AYAZ KHALEEQ MD

Authorized Official Title
PSYCHIATRIST
Authorized Official Phone
(971) 239-1146

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
R148780MEDICARE PIN (08)OR 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669704805, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
4
Doubled → 8
Pos 8
8
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 7 → 14 → 5 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 4 + 0 + 8 + 8 + 0 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1669704805.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Psychiatry & Neurology (Psychiatry)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Psychiatry & Neurology (Psychiatry)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Nurse Practitioner (Psychiatric/Mental Health)
1249 FAIRVIEW AVE SE
SALEM, OR 97302
Clinic/Center (Physical Therapy)
1249 FAIRVIEW AVE SE
SALEM, OR 97302

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669704805, enumerated as an "organization" on February 11, 2010.

The provider is located at 1249 FAIRVIEW AVE SE SALEM, OR 97302 and the phone number is (971) 239-1146.

Clinic/Center with taxonomy code 261QM0850X and a focus in Adult Mental Health.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.