Individual provider Active NPI

Samuel Slishman, MD

  • Emergency Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1225043789
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C55319 Issued in CA
Practice address
387 Lincoln St
San Luis Obispo, CA 93405-2331
Phone
(505) 220-1014
NPI assigned
Jul 30, 2006
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C55319 CA Primary

Addresses

Primary practice location

387 Lincoln St
San Luis Obispo, CA 93405-2331

Mailing address

387 Lincoln St
San Luis Obispo, CA 93405-2331
Phone (505) 220-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110113000411 HI Practitioner - Emergency Medicine 0446343016 Reassigns benefits to 1 organization
I20120824000763 CA Practitioner - Emergency Medicine 0446343016 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C55319CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Kauai Veterans Memorial Hospital Current Accepting new patients
Kauai Veterans Memorial Hospital CurrentSince Dec 1, 2010 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Dec 10, 2019 Accepting new patients
Cep America- California Emergency Medicine CurrentSince Dec 10, 2019 Accepting new patients
Central Coast Emergency Physicians Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Lea Emergency Group LLC Emergency Medicine Past Accepting new patients
NM Heart Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Eddy Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

300 Canal St
King City, CA 93930
Phone (831) 385-6000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1225043789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 LINCOLN ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934052331",
            "telephone_number": "505-220-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 LINCOLN ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934052331",
            "telephone_number": "505-220-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLISHMAN",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C55319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.