Individual provider Active NPI

Hannah Skylar Sledge, PA

  • Physician Assistant
  • Lake Grove, NY
National Provider Identifier
1750915252
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034485 Issued in NY
Practice address
4 Smith Haven Haven Mall
Suite 103
Lake Grove, NY 11755
Phone
(631) 444-4233
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 034485 NY Primary

Addresses

Primary practice location

4 Smith Haven Haven Mall
Suite 103
Lake Grove, NY 11755

Mailing address

4 Smith Haven Haven Mall
Suite 103
Lake Grove, NY 11755

Other names 1

  • Hannah Palau Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251022001118 NY Practitioner - Physician Assistant 4688162688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14 Technology Dr
Suite 11
East Setauket, NY 11733-3464
Phone (631) 444-4233

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Orthopaedic Associates, University Faculty Practice Corpor CurrentSince Oct 6, 2025 Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Past Accepting new patients
University Associates in Obstetrics & Gynecology, University Faculty P Past Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati PastSince Oct 12, 2025 Accepting new patients

Locations

500 Commack Rd
Unit 100
Commack, NY 11725
Phone (631) 221-6818

14 Technology Dr
Ste 11
East Setauket, NY 11733
Phone (631) 444-1496

4 Smith Haven Mall
Ste 103
Lake Grove, NY 11755

100 Nicolls Rd
Stony Brook, NY 11790
Phone (631) 444-1069

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Organizations & group practices 4

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1750915252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN HAVEN MALL",
            "address_2": "SUITE 103",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN HAVEN MALL",
            "address_2": "SUITE 103",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755",
            "telephone_number": "631-444-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEDGE",
        "first_name": "HANNAH",
        "middle_name": "SKYLAR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "PALAU",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.