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Individual provider Active NPI

Ryan L Slaba, PAC

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1194014894
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0776 Issued in SD
Practice address
810 E 23Rd St
Sioux Falls, SD 57105-2135
Phone
(605) 331-5890
NPI assigned
Apr 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0776 SD Primary

Addresses

Primary practice location

810 E 23Rd St
Sioux Falls, SD 57105-2135

Mailing address

810 E 23Rd St
Sioux Falls, SD 57105-2135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000579 SD Practitioner - Physician Assistant 1254519432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

310 22ND Ave
Brookings, SD 57006-2474

6100 S Louise Ave
Sioux Falls, SD 57108-6029

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0776SDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Mar 28, 2011 Accepting new patients
Avera McKennan CurrentSince Oct 28, 2019 Accepting new patients
Sanford Medical Center Physician Assistant CurrentSince Feb 1, 2012 Accepting new patients
Avera McKennan CurrentSince Oct 28, 2019 Accepting new patients
Sanford Clinic CurrentSince Mar 28, 2011 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

6215 S Cliff Ave
Ste 110
Sioux Falls, SD 57108
Phone (605) 322-4130

6100 S Louise Ave
Ste 1500
Sioux Falls, SD 57108
Phone (605) 504-1100

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1600 S Highline Ave
Ste 110
Sioux Falls, SD 57110
Phone (605) 504-5670

810 E 23rd St
Sioux Falls, SD 57105
Phone (605) 339-6823

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

6800 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 322-3278

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

Organizations & group practices 8

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1194014894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135",
            "telephone_number": "605-331-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLABA",
        "first_name": "RYAN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.