Individual provider Active NPI

Michele De Maria, MA, CCC-SLP

  • Speech-Language Pathologist
  • Glen Cove, NY
National Provider Identifier
1063666121
Registry record updated Nov 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
009022-1 Issued in NY
Practice address
12 Walnut Rd
Glen Cove, NY 11542-2227
Phone
(917) 282-2219
NPI assigned
Nov 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2008

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 009022-1 NY Primary

Addresses

Primary practice location

12 Walnut Rd
Glen Cove, NY 11542-2227

Mailing address

60 Baldwin Ave
Locust Valley, NY 11560-1921
Phone (917) 282-2219

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

LicenseStateTypeSpecialty
009022-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michele de Maria SLP, P.C. Speech-Language Pathologist Past Accepting new patients

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": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226707200000",
    "number": "1063666121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BALDWIN AVE",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601921",
            "telephone_number": "917-282-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WALNUT RD",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422227",
            "telephone_number": "917-282-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MARIA",
        "first_name": "MICHELE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-15",
        "last_updated": "2008-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "009022-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; 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.