Daniel Hogan Slack, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

176336 Issued in CA

Practice address

101 Bodin Circle
Internal Medicine Clinic
Fairfield, CA 94533

Phone

(707) 423-3000

NPI assigned

Apr 7, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

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

University of Colorado School of Medicine, Denver, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dslack654087@hisp.ehr.sutterhealth.org

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.

• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952327256

  Internal Medicine

  NPD

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

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1952864027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIRCLE",
            "address_2": "INTERNAL MEDICINE CLINIC",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIRCLE",
            "address_2": "INTERNAL MEDICINE CLINIC",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-423-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St # 1100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171460",
            "country_code": "US",
            "telephone_number": "916-734-2737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLACK",
        "first_name": "DANIEL",
        "middle_name": "HOGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-07",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "176336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyla Jessica Sison
• Richel Sison, PHARMTECH
• Henry Taylor Skidmore, DO
• Kristian Skillman, MFT
• Alexander Slabaugh
• Samone Slaughter
• Ricardo Slay
• Shayondelice Sledge
• Sleep Management Services
• Sleepmed of California

• Internal Medicine Physician in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.