Active NPI
Paul J Slavik, MD
- Internal Medicine Physician
- Portage, WI
National Provider Identifier
1649238932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20442-020
- Practice address
- 2825 Hunters TRL
1St Floor
Portage, WI 53901-3429 - Phone
- (608) 742-7161
- Fax
- (608) 745-3060
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20442-020 | WI | Primary |
Addresses
Primary practice location
2825 Hunters TRL
1St Floor
Portage, WI 53901-3429
Mailing address
2825 Hunters TRL
Portage, WI 53901-3429
Phone (608) 742-7161
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 339 | Other | WI | DEAN HEALTH INSURANCE |
| 1000292 | Other | WI | PHYSICIANS PLUS |
| 30108100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20442-020 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc, | Past | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Beaver Dam, WI
- NPI 1336425016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1649238932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 HUNTERS TRL",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539013429",
"telephone_number": "608-742-7161",
"fax_number": "608-745-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 HUNTERS TRL",
"address_2": "1ST FLOOR",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539013429",
"telephone_number": "608-742-7161",
"fax_number": "608-745-3060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAVIK",
"first_name": "PAUL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "20442-020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "339",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS",
"identifier": "1000292",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30108100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portage, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.