Individual provider Active NPI

Kristin Ponzini

  • Speech-Language Pathologist
  • Wading River, NY
National Provider Identifier
1023428018
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
154 Sylvan Dr
Wading River, NY 11792
Phone
(516) 220-8135
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

154 Sylvan Dr
Wading River, NY 11792

Mailing address

154 Sylvan Dr
Wading River, NY 11792-1852
Phone (516) 220-8135

Other practice location 1

6302 Route 25A
Suite 2
Wading River, NY 11792-2026
Phone (631) 325-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1023428018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 SYLVAN DR",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117921852",
            "telephone_number": "516-220-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 SYLVAN DR",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "11792",
            "telephone_number": "516-220-8135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6302 Route 25A",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Wading River",
            "state": "NY",
            "postal_code": "117922026",
            "country_code": "US",
            "telephone_number": "631-325-7755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONZINI",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.