Individual provider Active NPI

Michael Christian Slabaugh

  • Medical Physician Assistant
  • Salem, OR
National Provider Identifier
1689922676
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA159718 Issued in OR
Practice address
4747 Skyline Rd S Ste 100
Salem, OR 97306-5700
Phone
(503) 399-7520
Fax
(503) 362-7344
NPI assigned
Aug 22, 2012
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA159718 OR Primary

Addresses

Primary practice location

4747 Skyline Rd S Ste 100
Salem, OR 97306-5700

Mailing address

875 Oak St SE
Ste 3010
Salem, OR 97301
Phone (503) 399-7520

Other practice location 1

875 Oak St SE
Ste 3010
Salem, OR 97301
Phone (503) 399-7520

Other names 1

  • Michael Slabaugh Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121101000647 OR Practitioner - Physician Assistant 1951551738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Gastroenterology Consultants PCGroup PAC ID 4183611361, 15 clinicians

Practice addresses (Care Compare)

875 Oak St SE
Suite 3010
Salem, OR 97301-3978
Phone (503) 399-7520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
43.48 of 100Reported as group
Quality
48.4
Improvement activities
0
Cost
74.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1689922676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "address_2": "STE 3010",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 SKYLINE RD S STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973065700",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Oak St SE",
            "address_2": "Ste 3010",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "97301",
            "country_code": "US",
            "telephone_number": "503-399-7520",
            "fax_number": "503-362-7344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLABAUGH",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-22",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA159718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SLABAUGH",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.