Individual provider Active NPI

Leah Ivory

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1073997995
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
226 E 4TH St
Brooklyn, NY 11218-2304
Phone
(413) 222-0904
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

226 E 4TH St
Brooklyn, NY 11218-2304

Mailing address

226 E 4TH St
Brooklyn, NY 11218-2304
Phone (413) 222-0904

Other practice location 1

255 Executive Dr
Plainview, NY 11803-1718
Phone (516) 576-2040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201001373 NY Practitioner - Qualified Speech Language Pathologist 6103216452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wihd Inc CurrentSince Nov 1, 2021 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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1073997995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 E 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182304",
            "telephone_number": "413-222-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182304",
            "telephone_number": "413-222-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Plainview",
            "state": "NY",
            "postal_code": "118031718",
            "country_code": "US",
            "telephone_number": "516-576-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVORY",
        "first_name": "LEAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 6, 2021; 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.