Annelise Paige Slack, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1353

Phone

(516) 562-6000

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

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

Interoperability endpoints

• Direct secure messaging: aslack295128@northwell.direct-ci.com

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.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment Care Compare group

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

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1831868157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BELMONT AVE",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046435",
            "telephone_number": "631-338-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-562-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "ANNELISE",
        "middle_name": "PAIGE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Singler, NP
• Gregory Paul Siroky, M.D
• George Thomas Skevas, DDS
• Michelle Skidmore
• Erica Sarah Sklar, NP
• Dorothy Selverstone Slade, LCSW
• Kerrion Smith, ACNPC-AG
• Robert Smith, P.A.
• Benjamin Alex Solomon
• Haylee Alexa Solomon, DPT

• Surgical Physician Assistant in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.