MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) – Gerontology Nurse Practitioner, NPI 1205636370

MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) is a healthcare provider. based in Boerne, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials AGPCNP-BC. They hold a License No. 1192980 (TX). The NPI Number for MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) is 1205636370

Main info

Organization
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MR. DAVID RUSSELL SALAZAR (AGPCNP-BC)
NPI
1205636370
Phone
(210) 793-3120
Address
29629 ELKHORN RDG
Enumeration Date
17 March 2025
Last Update Date
15 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3163690106
Graduation Year
2024 (2 years ago)
PAC ID
8820273170
Group Practice PAC ID
7315331766
Professional Enrollment ID
I20250612001088
Address ID
TX782163962SA10300STXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MR. DAVID RUSSELL SALAZAR (AGPCNP-BC)

  • 29629 ELKHORN RDG

    BOERNE, TX 780155104

    Phone: (210) 793-3120

    Type: Mailing

  • 10300 HERITAGE ST STE 250

    SAN ANTONIO, TX 782163962

    Phone: (210) 375-4911

    Fax: (210) 855-5189

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250612001088INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315331766View full group profile
NameSpecialtyState
Nurse PractitionerTX

Reviews

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Frequently asked questions

Does MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) uses 1205636370.
Does CMS list MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) as active?
Yes — MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) is active in the NPI listing used on this page.
What is MR. DAVID RUSSELL SALAZAR (AGPCNP-BC)'s specialty?
The listing groups MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) with Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) based?
MR. DAVID RUSSELL SALAZAR (AGPCNP-BC) is tied to Boerne, Texas in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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