Individual provider Active NPI

Bethany J Slater, MD, MBA

  • Pediatric Surgery Physician
  • New York, NY
National Provider Identifier
1669668869
Registry record updated Aug 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
338344 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(650) 804-4140
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 036142224 IL
Pediatric Surgery Physician 2086S0120X 338344 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

188 E 70TH St Apt 8C
New York, NY 10021-5168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170301000984 IL Practitioner - General PracticePractitioner - General SurgeryPractitioner - Pediatric Medicine 0446565501 Reassigns benefits to 1 organization
I20251016001476 NY Practitioner - General Surgery 0446565501 Reassigns benefits to 1 organization
I20251223003300 NJ Practitioner - General Surgery 0446565501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Icahn School of Medicine at Mount Sinai, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 Essex Rd
Suite 501
Paramus, NJ 07652-1451

4 Valley Health PLZ
Paramus, NJ 07652-3619

7901 Broadway
Elmhurst, NY 11373-1329

7901 Broadway
RM A1 19
Elmhurst, NY 11373-1368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Pediatric Surgery CurrentSince Jul 12, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 20, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 20, 2017 Accepting new patients
University of Chicago CurrentSince Mar 15, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 12, 2025 Accepting new patients
Valley Physician Services PC CurrentSince Nov 3, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

29373 Network Pl
Chicago, IL 60673

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 8

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": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755302400000",
    "number": "1669668869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 E 70TH ST APT 8C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "650-804-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "BETHANY",
        "middle_name": "J",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2025-08-16",
        "certification_date": "2025-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036142224",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "338344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.