SLATE BELT FAMILY PRACTICE PC
NPI 1396715389
Family Medicine in Wind Gap, PA
About Slate Belt Family Practice Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SLATE BELT FAMILY PRACTICE PC (NPI 1396715389) is a healthcare organization registered as a family medicine in Wind Gap, Pennsylvania and active in the NPI registry since January 2006. The organization holds a CLIA Microscopy certificate valid through September 16, 2027 and lists Wayne J Brotzman, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Slate Belt Family Practice Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Slate Belt Family Practice PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 39D0876477
Slate Belt Family Practice · Wind Gap, PAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Slate Belt Family Practice PC's NPI number?
The NPI number for Slate Belt Family Practice PC is 1396715389. It was assigned to this organization in the NPPES registry on January 24, 2006.
Where is Slate Belt Family Practice PC located?
Slate Belt Family Practice PC is located at 826 S Broadway, Wind Gap, PA 18091. The listed phone number is (610) 863-3019.
What is Slate Belt Family Practice PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Slate Belt Family Practice PC enrolled in Medicare?
Yes. Slate Belt Family Practice PC is registered in the Medicare PECOS enrollment system.
When is Slate Belt Family Practice PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Slate Belt Family Practice PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Slate Belt Family Practice PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Slate Belt Family Practice PC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 39D0876477) is associated with this NPI, valid through September 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Slate Belt Family Practice PC was last updated on April 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Slate Belt Family Practice Pc · NPI 1396715389
Family Medicine organization in Wind Gap, Pennsylvania. Organization record, active in the CMS NPPES registry since January 24, 2006.
## Identity
- **NPI:** 1396715389 (Entity type: Organization)
- **Enumerated:** January 24, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Wayne Brotzman, PHYSICIAN
## Practice location
- **Address:** 826 S BROADWAY, Wind Gap, PA 18091-1628
- **Phone:** (610) 863-3019 · **Fax:** (610) 863-6732
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 24, 2008
- **Other identifiers:** Medicare PIN 122737 (PA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1396715389) · Data from the CMS NPPES public registry.