Active NPI
Joseph B Sleckman, MD
- Rheumatology Physician
- Fargo, ND
National Provider Identifier
1184652414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 4923
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- Fax
- (701) 364-8906
- NPI assigned
- Jun 28, 2006
- Last updated
- Aug 26, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 4923 | ND | Primary |
| Rheumatology Physician | 207RR0500X | 29183 | MN |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-3300
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10016 | Other | MN | NDBS # |
| 3200072 | Other | ND | MEDICA # |
| 54828SL | Other | MN | MNBS # |
| 91643SL | Other | ND | MNBS # |
| 06335SL | Other | ND | MNBS # |
| 2284 | Other | ND | NDBS # |
| 48617SL | Other | MN | MNBS # |
| 911594 | Other | ND | AMERICA'S PPO/ARAZ # |
| ND200061 | Other | ND | LHS # |
| 14356 | Medicaid | ND | |
| 6430 | Other | MN | NDBS # |
| 1285 | Other | ND | NDBS # |
| 79889SL | Other | ND | MNBS # |
| DA9011015589 | Other | ND | PREFERRED ONE # |
| 3200086 | Other | ND | MEDICA # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29183 | MN | MD | Clinical Social Worker |
| 4923 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1184652414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLECKMAN",
"first_name": "JOSEPH",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "ND",
"license": "4923",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MN",
"license": "29183",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "10016",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "3200072",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "54828SL",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "91643SL",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "06335SL",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "2284",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "48617SL",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO/ARAZ #",
"identifier": "911594",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS #",
"identifier": "ND200061",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "14356",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "6430",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "1285",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "79889SL",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9011015589",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "3200086",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.