Mark R Slack, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

0101044713 Issued in VA

Practice address

8700 Sudley Rd
Manassas, VA 20110-4418

Phone

(703) 369-8000

NPI assigned

Jul 11, 2006

Last updated

Feb 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Anesthesiology of Virginia PC

  • Anesthesiology Physician
  • Falls Church, VA
  • NPI 1417994872
  NPD
• American Anesthesiology of Virginia, PC

  • Anesthesiology Physician
  • Leesburg, VA
  • NPI 1053675199
  NPD
• Ambulatory Anesthesia Associates LLC

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1720192230
  NPD (past)
• Loudoun Anesthesia Associates

  • Anesthesiology Physician
  • Potomac Falls, VA
  • NPI 1629017645
  NPD (past)
• Professional Anesthesia Group, LLC

  • Anesthesiology Physician
  • Fredericksburg, VA
  • NPI 1619149648
  NPD (past)
• Reston Anesthesia Associates, PC

  • Anesthesiology Physician
  • Reston, VA
  • NPI 1932210093
  NPD (past)
• Medstar Surgery Center at Timonium, LLC

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1033635206
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1679508618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-882-7908",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104418",
            "telephone_number": "703-369-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101044713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "191639",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010094291",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Igor Sirotkin, M.D.
• Shonette Skeete
• Alexandra Skinner
• Jeffrey J Skovronsky, MD
• Sky Residiential Care Services LLC
• Simeon Charles Slayton II, MS
• Sleep Disorders CTRS of the Mid Atlantic LLC
• Sleepcare Inc.
• Jane Thompson Slomski, LCSW
• Katelyn Louise Slone, LPC

• Anesthesiology Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.