NPIMap

Individual provider Active NPI

Doreen Ann Slabaugh, D.O.

  • Internal Medicine Physician
  • Prescott, AZ
National Provider Identifier
1619964061
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4226 Issued in AZ
Practice address
300 N Lee Blvd
Prescott, AZ 86301-5710
Phone
(928) 708-4300
Fax
(928) 458-2122
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4226 AZ Primary

Addresses

Primary practice location

300 N Lee Blvd
Prescott, AZ 86301-5710

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
957962MedicaidAZ

Other names 1

  • Doreen Ann Traina-Penny Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051025000450 AZ Practitioner - Internal Medicine 6103860127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone (928) 771-3704

Hospital & facility affiliations

  • Angels Care Home Health of Arizona Home health agency, Cottonwood, AZ, CCN 037217
  • Nurses Network by Quality Home Health Care Home health agency, Prescott Valley, AZ, CCN 037154
  • Mountain Valley Home for Health Home health agency, Prescott Valley, AZ, CCN 037456
  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012
  • Mountain Valley Regional Rehabilitation Hospital Inpatient rehabilitation facility, Prescott Valley, AZ, CCN 033036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4226AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Jul 13, 2020 Accepting new patients
Kidney Guardian Internal Medicine Past Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

300 N Lee Blvd
Prescott, AZ 86301
Phone (928) 708-4300

Organizations & group practices 4

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 5

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1619964061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N LEE BLVD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015710",
            "telephone_number": "928-708-4300",
            "fax_number": "928-458-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLABAUGH",
        "first_name": "DOREEN",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "4226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "957962",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOREEN",
            "last_name": "TRAINA-PENNY",
            "middle_name": "ANN",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.