Kaila C Bardoo, M.S., CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

624 Hawkins Ave
Ronkonkoma, NY 11779-2375

Phone

(631) 240-3579

NPI assigned

May 10, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Simply You Speech Therapy, PLLC

  • Hearing and Speech Clinic/Center
  • Bay Shore, NY
  • NPI 1346058385
  NPD Authorized official
• Theralympic Speech Therapy PLLC

  • Early Intervention Provider Agency
  • Ronkonkoma, NY
  • NPI 1730665043

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1003490665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 PETERS BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064848",
            "telephone_number": "516-473-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HAWKINS AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117792375",
            "telephone_number": "631-240-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDOO",
        "first_name": "KAILA",
        "middle_name": "C",
        "credential": "M.S., CCC-SLP, TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2023-09-24",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meagan Baker, B.A
• George Kendrick Balkam, LMSW
• Cynthia A Bangs
• Jillian Marie Bankoff, PHARMD
• Michael Baptiste
• Bari Home Care LLC
• Amanda Baron, MHC-LP
• Ralph J Barone, MS
• Diane Lynn Barricelle, COTA
• Joanna Lena Barry, M.S.

• Speech-Language Pathologist in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.