NPIMap

Organization Active NPI

Northwest Iowa Surgeons PC

  • Surgery Physician
  • Spencer, IA
National Provider Identifier
1295713261
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHWEST IOWA SURGEONS PC
Practice address
1823 Highway Blvd Ste 5
Spencer, IA 51301-2226
Phone
(712) 262-6320
Fax
(952) 442-3620
NPI assigned
Jan 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Patrick J Slattery, MD, FACSNPI 1740269224
Title
President
Phone
(712) 262-6320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1823 Highway Blvd Ste 5
Spencer, IA 51301-2226

Mailing address

400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770

Other practice location 1

1200 1st Ave E
Spencer, IA 51301-4342
Phone (712) 262-6320

Other identifiers 1

IdentifierTypeStateIssuer
0415950MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000834 IA Part B Supplier - Clinic/Group Practice 5799677845 Receives reassigned benefits from 5 practitioners
Practice locations: Emmetsburg, IA; Estherville, IA; Pocahontas, IA; Spencer, IA; Spirit Lake, IA

National Provider Directory

National Provider Directory

Locations

1823 Highway Blvd
Spencer, IA 51301

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1295713261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 HIGHWAY BLVD STE 5",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513012226",
            "telephone_number": "712-262-6320",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 1st Ave E",
            "address_purpose": "LOCATION",
            "city": "Spencer",
            "state": "IA",
            "postal_code": "513014342",
            "country_code": "US",
            "telephone_number": "712-262-6320",
            "fax_number": "712-264-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST IOWA SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-262-6320",
        "authorized_official_credential": "MD, FACS"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415950",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.