Active NPI
Jenna M Pellegriti, M.A
- Speech-Language Pathologist
- Brooklyn, NY
National Provider Identifier
1053715367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 024285
- Practice address
- 150 55TH St
Brooklyn, NY 11220-2508 - Phone
- (718) 630-7000
- NPI assigned
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 024285-1 | NY | |
| Speech-Language Pathologist | 235Z00000X | 024285 | NY | Primary |
Addresses
Primary practice location
150 55TH St
Brooklyn, NY 11220-2508
Mailing address
21 Arrowood CT
Staten Island, NY 10309-4221
Phone (347) 489-5395
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04062557 | Medicaid | NY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Jericho | ||
| Other URL | Jericho |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024285 | NY | MD | Clinical Psychologist |
| 024285-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1053715367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 ARROWOOD CT",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103094221",
"telephone_number": "347-489-5395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 55TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112202508",
"telephone_number": "718-630-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLEGRITI",
"first_name": "JENNA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "M.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-15",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "024285-1",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "024285",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04062557",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Jericho",
"affiliation": "N",
"address_1": "33 White Place",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "10310",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Jericho",
"affiliation": "N",
"address_1": "33 White Place",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "10310",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.