Christopher Lee Slack, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

ME84369 Issued in FL

Practice address

4632 S 25TH St
Fort Pierce, FL 34981-5057

Phone

(772) 464-9595

Fax

(772) 464-9582

NPI assigned

Aug 8, 2006

Last updated

Jul 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Tufts University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246
• St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260
• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cslack@entaaf.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• ENT and Allergy Associates of Florida, LLC

  • Otolaryngology Physician
  • Boca Raton, FL
  • NPI 1164473120
  Medicare reassignment Care Compare group NPD
• Surgical Specialists of St Lucie

  dba Blue Water Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Port St Lucie, FL
  • NPI 1164719209
  NPD
• Treasure Coast Sleep Disorders , LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Port St Lucie, FL
  • NPI 1649551235
  NPD
• Treasure Coast Sleep Disorders LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Jensen Beach, FL
  • NPI 1356363212
  NPD

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

• HCA Health Services of Florida, Inc.

  dba HCA Florida St. Lucie Hospital

  • General Acute Care Hospital
  • Port St Lucie, FL
  • NPI 1538115696
  Care Compare affiliation
• Lawnwood Medical Center Inc

  dba HCA Florida Lawnwood Hospital

  • General Acute Care Hospital
  • Fort Pierce, FL
  • NPI 1568409647
  Care Compare affiliation
• Martin Memorial Medical Center Inc

  dba Cleveland Clinic Martin North, South, Tradition Hospitals

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1982613717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-464-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-464-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "FL",
            "license": "ME84369",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CO",
            "license": "36380",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264157700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly N. Singh, LCSW
• Sonya Kiran Singh, PHARMD
• Yaisha Monique Sirmons, LMT
• Lauren Sisselberger, M.ED.
• Jamie Skuba, D.C.
• Lauren Slack, FNP-C
• SLC Advanced Practice LLC
• Sleep Center of South Florida Inc.
• Emmaleigh Sloan
• Michael Sean Slobasky, D.O.

• Facial Plastic Surgery Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Facial Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.