Kaeli Dieckert

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

026771-1 Issued in NY

Practice address

413 Bay Rd
Queensbury, NY 12804-1408

Phone

(518) 761-2025

NPI assigned

Jul 18, 2017

Last updated

Jan 6, 2020By the provider in NPPES

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

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Binghamton, NY
  • NPI 1316088941
  NPD

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1053834440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041408",
            "telephone_number": "518-761-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKERT",
        "first_name": "KAELI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "026771-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Denison, P.T, DPT
• Kaylee Marie Deprato, COTA/L
• Calan Howard Deuso, PA-C
• Louise Marie Devivo, DPT
• Isabelle Dickens, MS ED.
• Honor Alyssa Dimezza, MHC-LP
• Richard N Dimick, M.D.
• DME Consulting Agency LLC (Kinney Homecare Equipment and Supplies)
• Lilianne N Dobert, LCSW-R
• David Matthew Dolinsky, M.D.

• Speech-Language Pathologist in Queensbury, NY
• Providers in Queensbury, 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 Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.