Individual provider Active NPI

Jeremy D Slater, M.D.

  • Clinical Neurophysiology Physician
  • Houston, TX
National Provider Identifier
1902833593
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
L8510 Issued in TX
Practice address
6410 Fannin St
1014
Houston, TX 77030-3000
Phone
(832) 325-7080
Fax
(713) 512-2239
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X L8510 TX
Clinical Neurophysiology Physician 2084N0600X L8510 TX Primary

Addresses

Primary practice location

6410 Fannin St
1014
Houston, TX 77030-3000

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 3

IdentifierTypeStateIssuer
164376901MedicaidTX
164376902OtherTXCSHCN
8F6715OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040429000649 TX Practitioner - Neurology 6406843556 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L8510TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 1, 2020 Accepting new patients
Maryland Neurodiagnostics, LLC CurrentSince Oct 1, 2021 Accepting new patients
Stratus DX, LLC CurrentSince Nov 1, 2021 Accepting new patients
Ozarks Medical Center Neurology Past Accepting new patients

Locations

5410 West Loop S
Bellaire, TX 77401
Phone (713) 314-4444

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

6410 Fannin St
#1028
Houston, TX 77030
Phone (713) 704-0780

6410 Fannin St
Ste 1014
Houston, TX 77030
Phone (713) 500-7100

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1902833593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "1014",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-7080",
            "fax_number": "713-512-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "JEREMY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L8510",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "L8510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164376901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "164376902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F6715",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.