Individual provider Active NPI

Kelly Lauren Sloane

  • Vascular Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1336583723
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
MD468964 Issued in PA
Practice address
3400 Spruce Street
Philadelphia, PA 19104-3309
Phone
(215) 349-8310
Fax
(215) 893-7270
NPI assigned
Apr 29, 2013
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD468964 PA
Vascular Neurology Physician 2084V0102X MD468964 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Philadelphia, PA 19104-3309

Mailing address

3400 Spruce Street
Philadelphia, PA 19104-3309
Phone (215) 349-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200827002692 PA Practitioner - Neurology 2769796242 Reassigns benefits to 1 organization
I20211029002040 NJ Practitioner - Physical Medicine and Rehabilitation 2769796242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Johns Hopkins University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 349-8310

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD468964PAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Aug 6, 2020 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. Internal Medicine CurrentSince Jul 28, 2021 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jul 28, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 6, 2020 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 7

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 2

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1336583723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-349-8310",
            "fax_number": "215-893-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-349-8310",
            "fax_number": "215-893-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOANE",
        "first_name": "KELLY",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD468964",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "MD468964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.