Individual provider Active NPI

Andrew Joseph Slavico, MD

  • Family Medicine Physician
  • McDonough, GA
National Provider Identifier
1255486056
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
037691 Issued in GA
Practice address
4303 Jodeco Rd
McDonough, GA 30253-8297
Phone
(770) 898-7840
Fax
(770) 898-7960
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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 037691 GA Primary

Addresses

Primary practice location

4303 Jodeco Rd
McDonough, GA 30253-8297

Mailing address

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005-4414
Phone (770) 442-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000803 GA Practitioner - Family Practice 8426950056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

1255 Friendship Rd
Suite 130
Braselton, GA 30517-5617
Phone (770) 442-1911

4303 Jodeco Rd
McDonough, GA 30253-8297
Phone (770) 442-1911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037691GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients

Locations

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005
Phone 7704421911233

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4303 Jodeco Rd
McDonough, GA 30253
Phone (770) 898-7840

Interoperability endpoints

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

Organizations & group practices 5

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 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1255486056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY",
            "address_2": "STE C270",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054414",
            "telephone_number": "770-442-1911",
            "fax_number": "770-663-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 JODECO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538297",
            "telephone_number": "770-898-7840",
            "fax_number": "770-898-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVICO",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "037691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.