Stacy N Slade, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004319 Issued in MI

Practice address

1225 W Front St
Traverse City, MI 49684-2368

Phone

(231) 935-0788

Fax

(231) 935-0787

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy N Bienkowski Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Dermatology of Traverse City PCGroup PAC ID 4981607298, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Merit-based Incentive Payment System (MIPS)

Final score

79.53 of 100Reported as individual

Quality

63.33

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Associates in Dermatology of Traverse City PC

  • Dermatopathology Physician
  • Traverse City, MI
  • NPI 1861430779
  Medicare reassignment Care Compare group
• McLaren Flint

  • General Practice Physician
  • Flint, MI
  • NPI 1275807372

  Physician Assistant

  NPD (past)
• Partners in Health of Traverse City

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1104124171
  NPD (past)
• Urgent Care of Traverse City PLLC

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1851344964
  NPD (past)

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

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409529600000",
    "number": "1265459267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842368",
            "telephone_number": "231-935-0788",
            "fax_number": "231-935-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842368",
            "telephone_number": "231-935-0788",
            "fax_number": "231-935-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "STACY",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "BIENKOWSKI",
            "middle_name": "N",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kacey Jo Skelly, DC
• Michael Scott Skelly, DC
• William Ensing Skillman, M.A., L.L.P.
• Michael Joseph Skipski, OD
• Nancy L Slabosz, NP
• Leslie Ellen Sladek
• Jill Slagal, PT
• Jason Dennis Slank, RN
• Laura Lee Slaughter, MSW
• William Stephen Slavin, LLP LMSW

• Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.