NPIMap

Individual provider Active NPI

Michael Slattery, MD

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Ithaca, NY
National Provider Identifier
1609877158
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
220740 Issued in NY
Practice address
8 Brentwood Dr
Ithaca, NY 14850-1871
Phone
(607) 273-6757
Fax
(607) 273-2854
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 220740 NY Primary
Neurology Physician 2084N0400X 220740 NY
Clinical Neurophysiology Physician 2084N0600X 220740 NY

Addresses

Primary practice location

8 Brentwood Dr
Ithaca, NY 14850-1871

Mailing address

821 Cliff St
Ithaca, NY 14850-2097
Phone (607) 277-2365

Other identifiers 1

IdentifierTypeStateIssuer
02136987MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904002710 TN Practitioner - Sleep MedicinePractitioner - NeurologyPractitioner - Psychiatry 7719933597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Neurology, Psychiatry
Education
Tufts University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1928 Alcoa Hwy
B119
Knoxville, TN 37920-1502
Phone (865) 544-8761

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc Current Accepting new patients
Regional Health Diagnostics Inc CurrentSince Jul 1, 2024 Accepting new patients
University Health System Inc CurrentSince Jul 1, 2019 Accepting new patients
University Health System, Inc CurrentSince Jul 1, 2019 Accepting new patients
United Health Services Hospitals, Inc. PastSince Jan 1, 2010 Accepting new patients
Cayuga Medical Associates, PC PastSince Sep 1, 2006 Accepting new patients

Locations

1928 Alcoa Hwy
Ste B119
Knoxville, TN 37920
Phone (865) 544-8761

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

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 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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1609877158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 CLIFF ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502097",
            "telephone_number": "607-277-2365",
            "fax_number": "607-277-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 BRENTWOOD DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501871",
            "telephone_number": "607-273-6757",
            "fax_number": "607-273-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NY",
            "license": "220740",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "220740",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "220740",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02136987",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.