Individual provider Active NPI

Leigh Ann Slater, M.D.

  • Surgical Critical Care Physician
  • Santa Rosa, CA
National Provider Identifier
1356546774
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
134762 Issued in CA
Practice address
1165 Montgomery Dr
Santa Rosa, CA 95405-4897
Phone
(707) 230-1534
NPI assigned
Jun 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 134762 CA
Surgery Physician 208600000X D74206 MD
Surgical Critical Care Physician 2086S0102X D74206 MD
Surgical Critical Care Physician 2086S0102X MD2015-0146 NM
Surgical Critical Care Physician 2086S0102X CS00221453 NM
Trauma Surgery Physician 2086S0127X D74206 MD
Trauma Surgery Physician 2086S0127X 134762 CA
Surgical Critical Care Physician 2086S0102X 134762 CA Primary

Addresses

Primary practice location

1165 Montgomery Dr
Santa Rosa, CA 95405-4897

Mailing address

250 Bicentennial Way Apt 711
Santa Rosa, CA 95403-7421
Phone (707) 230-1534

Other practice location 1

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (707) 230-1534

Other identifiers 1

IdentifierTypeStateIssuer
055296800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NM2 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
I20150515001210 CA Practitioner - Critical Care (Intensivists) 6709041528 Reassigns benefits to 2 organizations
I20150604002134 NM Practitioner - General Surgery 6709041528

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

2710 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 267-2060

400 N McDowell Blvd
Petaluma, CA 94954-2339
Phone (707) 778-2631

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136
  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134762CAMDClinical Social Worker
D74206MDMDSurgery Physician
CS00221453NMMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 1, 2015 Accepting new patients
Providence Medical Foundation CurrentSince Nov 1, 2015 Accepting new patients
Inpatient Specialists of California, PC CurrentSince Dec 1, 2015 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients

Locations

1375 University St
Healdsburg, CA 95448
Phone (707) 385-2025

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

31700 Temecula Pkwy
Temecula, CA 92592
Phone (951) 303-8939

Interoperability endpoints

  • Direct secure messaging: lslater1658325@oc.providencedirect.org

Organizations & group practices 6

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 6

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": "1181952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1356546774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BICENTENNIAL WAY APT 711",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037421",
            "telephone_number": "707-230-1534",
            "fax_number": "707-303-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054897",
            "telephone_number": "707-230-1534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 N Waterman Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924044836",
            "country_code": "US",
            "telephone_number": "707-230-1534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATER",
        "first_name": "LEIGH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-16",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "134762",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D74206",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D74206",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NM",
            "license": "MD2015-0146",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NM",
            "license": "CS00221453",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MD",
            "license": "D74206",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "134762",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "134762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055296800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.