NPIMap

Individual provider Active NPI

Paul Sliskovich, MD

  • Family Medicine Physician
  • Gardena, CA
National Provider Identifier
1245892934
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A177549 Issued in CA
Practice address
18726 S Western Ave Ste 409
Gardena, CA 90248-3858
Phone
(310) 819-8582
NPI assigned
Jul 2, 2019
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A177549 CA Primary

Addresses

Primary practice location

18726 S Western Ave Ste 409
Gardena, CA 90248-3858

Mailing address

18726 S Western Ave Ste 409
Gardena, CA 90248-3858
Phone (310) 819-8582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220715000318 CA Practitioner - General PracticePractitioner - Family Practice 1456680446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
Creighton University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Mona Shah Professional CorporationGroup PAC ID 2062548084, 11 clinicians
Neuro Fitness Medical CorporationGroup PAC ID 8325404585, 2 clinicians

Practice addresses (Care Compare)

1366 W 7TH St
San Pedro, CA 90732-3500
Phone (310) 833-2461

18726 S Western Ave
Suite 409
Gardena, CA 90248-3858
Phone (310) 819-8582

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177549CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mona Shah Professional Corporation CurrentSince Jul 1, 2022 Accepting new patients
Neuro Fitness Medical Corporation CurrentSince Mar 1, 2023 Accepting new patients
Zeljko Zic M.D. Inc. Past Accepting new patients

Locations

18726 S Western Ave
Ste 409
Gardena, CA 90248
Phone (310) 329-4835

1294 W 6th St
Ste 205
San Pedro, CA 90731
Phone (310) 548-0201

1366 W 7th St
San Pedro, CA 90732
Phone (310) 548-0478

1600 S Gaffey St
San Pedro, CA 90731
Phone (310) 548-0201

621 S Butte St
San Pedro, CA 90732
Phone (310) 548-1422

621 S Butte St
Ste Reet
San Pedro, CA 90732

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJGBDD/Endpoint/FJGBDD

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1245892934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 409",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-819-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 409",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-819-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLISKOVICH",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A177549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.