Individual provider Active NPI

Cynthia Marie Slaga, OTR/L, RN, MSN, PNP

  • Pediatric Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1528106796
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2258341 Issued in MA
Practice address
55 Dimock St
Pediatrics
Roxbury, MA 02119-1029
Phone
(617) 254-1140
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN2258341 MA
Pediatric Nurse Practitioner 363LP0200X RN2258341 MA Primary

Addresses

Primary practice location

55 Dimock St
Pediatrics
Roxbury, MA 02119-1029

Mailing address

36 Diamond Dr
Dracut, MA 01826-1443
Phone (617) 312-5946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110920000228 MA Practitioner - Nurse Practitioner 4587835764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
8673MAMDMental Health Counselor
RN2258341MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Mar 21, 2016 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Mar 21, 2016 Accepting new patients

Locations

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

Interoperability endpoints

  • Direct secure messaging: cslaga20969@direct.ctc.masshiway.net

Organizations & group practices 2

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1528106796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DIAMOND DR",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018261443",
            "telephone_number": "617-312-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "address_2": "PEDIATRICS",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-254-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAGA",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "OTR/L, RN, MSN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2258341",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2258341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.