Petra Massis, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

A60879991 Issued in VA

Practice address

13582 Big Boulder Rd
Herndon, VA 20171-5000

Phone

(571) 329-2658

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Massis Speech & Language PLLC

  • Speech-Language Pathologist
  • Herndon, VA
  • NPI 1457227670
  NPD Authorized official
• Sunrise Therapy

  • Early Intervention Provider Agency
  • Lakewood, NJ
  • NPI 1427388610

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1073255618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13582 BIG BOULDER RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715000",
            "telephone_number": "571-329-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13582 BIG BOULDER RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715000",
            "telephone_number": "571-329-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIS",
        "first_name": "PETRA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "A60879991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel F Martino, LPC, CSAC
• Sofia Marzo
• Jason Leo Maslow, PA
• Massis Speech & Language PLLC
• Maher Massis
• Deepika Mathialagan
• Hunter Daniel Mathias, DPT, PT, ATC, AEMT
• Mavens DME Care Supply LLC
• Nair Maya, M.D.
• Mazin Alayssami, DMD & Associates PC

• Speech-Language Pathologist in Herndon, VA
• Providers in Herndon, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.