Individual provider Active NPI

Stacy Marie Slaven, M.D.

  • Rheumatology Physician
  • Floral Park, NY
National Provider Identifier
1275862690
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
249321 Issued in NY
Practice address
26112 E Williston Ave
Floral Park, NY 11001-1145
Phone
(718) 347-8888
Fax
(718) 347-8889
NPI assigned
Dec 14, 2009
Last updated
Jan 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 249321 NY
Rheumatology Physician 207RR0500X 249321 NY Primary

Addresses

Primary practice location

26112 E Williston Ave
Floral Park, NY 11001-1145

Mailing address

26112 E Williston Ave
Floral Park, NY 11001-1145
Phone (718) 347-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Medical & Surgical Associates PastSince Jan 1, 2012 Accepting new patients

Organizations & group practices 1

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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1275862690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26112 E WILLISTON AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110011145",
            "telephone_number": "718-347-8888",
            "fax_number": "718-347-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26112 E WILLISTON AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110011145",
            "telephone_number": "718-347-8888",
            "fax_number": "718-347-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVEN",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "249321",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "249321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.