Individual provider Active NPI

Mary Gagliardotto, MA, CF-SLP

  • Speech-Language Pathologist
  • Montclair, NJ
National Provider Identifier
1053195800
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
17 Watchung PLZ
Montclair, NJ 07042-4117
Phone
(973) 744-0804
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

17 Watchung PLZ
Montclair, NJ 07042-4117

Mailing address

30 Oweno Rd
Mahwah, NJ 07430-1829
Phone (551) 427-6588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331003163 NJ Practitioner - Qualified Speech Language Pathologist 3375066376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lori Speaks, LLCGroup PAC ID 0446569644, 16 clinicians

Practice addresses (Care Compare)

17 Watchung PLZ
Montclair, NJ 07042-4117
Phone (973) 744-0804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Lori Speaks, LLC Speech-Language Pathologist CurrentSince Mar 25, 2025 Accepting new patients

Locations

17 Watchung Plz
Montclair, NJ 07042
Phone (973) 744-0804

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1053195800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OWENO RD",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301829",
            "telephone_number": "551-427-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WATCHUNG PLZ",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424117",
            "telephone_number": "973-744-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIARDOTTO",
        "first_name": "MARY",
        "credential": "MA, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.