Individual provider Active NPI

Theodore A. Slater III, M.D.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1548239155
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35086677 Issued in OH
Practice address
750 Mount Carmel Mall
Suite 300
Columbus, OH 43222-1553
Phone
(614) 224-6420
Fax
(614) 224-6423
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35086677 OH Primary

Addresses

Primary practice location

750 Mount Carmel Mall
Suite 300
Columbus, OH 43222-1553

Mailing address

PO Box 713189
Columbus, OH 43271-3189
Phone (440) 777-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000515 OH Practitioner - Emergency Medicine 4385698612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.44 of 100Reported as group
Quality
88.85
Improvement activities
40
Cost
86.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35086677OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services, Inc. Emergency Medicine CurrentSince Oct 17, 2005 Accepting new patients
Emergency Services, Inc. Emergency Medicine CurrentSince Oct 17, 2005 Accepting new patients
Emergency Room Care Providers, S.C. Emergency Medicine PastSince Jul 25, 2019 Accepting new patients

Locations

7911 Diley Rd
Canal Winchester, OH 43110
Phone (614) 838-7911

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

Organizations & group practices 3

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548239155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713189",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432713189",
            "telephone_number": "440-777-6017",
            "fax_number": "440-777-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MOUNT CARMEL MALL",
            "address_2": "SUITE 300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221553",
            "telephone_number": "614-224-6420",
            "fax_number": "614-224-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "THEODORE",
        "middle_name": "A.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35086677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.