Individual provider Active NPI

Victor Stephen Slana, MD

  • Ophthalmology Physician
  • Kenosha, WI
National Provider Identifier
1730155573
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
32916 Issued in WI
Practice address
6125 Green Bay Rd
Ste 800
Kenosha, WI 53142-2928
Phone
(262) 654-0726
Fax
(262) 654-4365
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 32916 WI Primary
Ophthalmology Physician 207W00000X 036082657 IL

Addresses

Primary practice location

6125 Green Bay Rd
Ste 800
Kenosha, WI 53142-2928

Mailing address

6125 Green Bay Rd
Suite 800
Kenosha, WI 53142-2928
Phone (262) 654-0726

Other identifiers 1

IdentifierTypeStateIssuer
31792900MedicaidWI

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

LicenseStateTypeSpecialty
036082657ILMDOphthalmology Physician
32916WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenosha Radiology Center LLC. Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1730155573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 GREEN BAY RD",
            "address_2": "SUITE 800",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422928",
            "telephone_number": "262-654-0726",
            "fax_number": "262-654-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 GREEN BAY RD",
            "address_2": "STE 800",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422928",
            "telephone_number": "262-654-0726",
            "fax_number": "262-654-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLANA",
        "first_name": "VICTOR",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "32916",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036082657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31792900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.