Charles A Slattery, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0051997 Issued in FL

Practice address

7455 S US Highway 1
Titusville, FL 32780-8115

Phone

(321) 264-2100

Fax

(321) 264-2485

NPI assigned

Jun 6, 2007

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 4

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• South Titusville Medical Center Inc

  • Health Service Clinic/Center
  • Titusville, FL
  • NPI 1821031683
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Brevard County Hospital District

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1821291048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7455 S US HIGHWAY 1",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327808115",
            "telephone_number": "321-264-2100",
            "fax_number": "321-264-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 S US HIGHWAY 1",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327808115",
            "telephone_number": "321-264-2100",
            "fax_number": "321-264-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0051997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "04843",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062108100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME0051997",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110165605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianne Mary Sindermann, O.T.
• Sister 2 Sister Home Care
• Angela Jo Ann Skroch
• Stephen Slade, DDS
• Annmarie Slater, LPN
• Frederick Raymond Smith Jr., MD
• Jessica L Smith, LMHC
• Stephanie D Smith
• Steven Louis Smith, D.C.
• Jaime Brooke Smyth

• Internal Medicine Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.