Individual provider Active NPI

Jane B Statlander-Slote

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1457973919
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17253 Issued in FL
Practice address
2630 SE Willoughby Blvd # 2B
Stuart, FL 34994-4700
Phone
(772) 486-4417
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17253 FL Primary

Addresses

Primary practice location

2630 SE Willoughby Blvd # 2B
Stuart, FL 34994-4700

Mailing address

2630 SE Willoughby Blvd # 2B
Stuart, FL 34994-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200605000592 FL Practitioner - Clinical Social Worker 4587085204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mind Body Therapeutics LLCGroup PAC ID 2769803485, 2 clinicians

Practice addresses (Care Compare)

5156 NW 26TH Cir
Boca Raton, FL 33496-2210

8461 Lake Worth Rd
Suite 126
Lake Worth, FL 33467-2474
Phone (772) 486-4417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17253FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Therapeutics LLC Clinical CurrentSince May 8, 2020 Accepting new patients

Locations

2630 SE Willoughby Blvd
#2B
Stuart, FL 34994
Phone (772) 486-4417

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1457973919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 SE WILLOUGHBY BLVD # 2B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 SE WILLOUGHBY BLVD # 2B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944700",
            "telephone_number": "772-486-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATLANDER-SLOTE",
        "first_name": "JANE",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.