Active NPI
Keimun A Slaughter, M.D.
- Facial Plastic Surgery Physician
- Latham, NY
National Provider Identifier
1073756649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- 279519
- Practice address
- 1072 Troy Schenectady Rd
Latham, NY 12110-1019 - Phone
- (518) 786-7000
- NPI assigned
- Apr 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | 279519 | NY | Primary |
Addresses
Primary practice location
1072 Troy Schenectady Rd
Latham, NY 12110-1019
Mailing address
2301 Erwin Rd
Durham, NC 27710-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04156718 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150611001585 | NY | Practitioner - Otolaryngology | 8628399961 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Morehouse School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Edwin F Williams III MD Facial Plastic Surgery PLLC
Practice addresses (Care Compare)
1072 Troy Schenectady Rd
Latham, NY 12110-1019
Phone (518) 283-2402
Hospital & facility affiliations
- Albany Medical Center Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 57 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwin F Williams III MD Facial Plastic Surgery, PLLC | Current | Accepting new patients |
Locations
1072 Troy Schenectady Rd
Latham, NY 12110
Phone (518) 283-2402
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- Latham, NY
- NPI 1679565410
NY
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Niskayana, NY
- NPI 1154973071
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1073756649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1072 TROY SCHENECTADY RD",
"city": "LATHAM",
"state": "NY",
"postal_code": "121101019",
"telephone_number": "518-786-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAUGHTER",
"first_name": "KEIMUN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-13",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "NY",
"license": "279519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04156718",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.