Individual provider Active NPI

Danielle H Tedesco, M.A.

  • Speech-Language Pathologist
  • Tonawanda, NY
National Provider Identifier
1083992168
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
022318-1 Issued in NY
Practice address
1500 Colvin Blvd
Tonawanda, NY 14223-1118
Phone
(716) 874-8400
NPI assigned
Jul 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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 022318-1 NY Primary

Addresses

Primary practice location

1500 Colvin Blvd
Tonawanda, NY 14223-1118

Mailing address

1138 Brighton Rd
Tonawanda, NY 14150-8311
Phone (716) 628-1137

Other practice location 1

25 Chateau Ter
Amherst, NY 14226-3927
Phone (716) 628-1137

Other names 1

  • Danielle H Forrest Former name

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
022318-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenmore-Town of Tonawanda Ufsd 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": "1311465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1083992168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508311",
            "telephone_number": "716-628-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COLVIN BLVD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "142231118",
            "telephone_number": "716-874-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Chateau Ter",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142263927",
            "country_code": "US",
            "telephone_number": "716-628-1137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDESCO",
        "first_name": "DANIELLE",
        "middle_name": "H",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-24",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022318-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "FORREST",
            "middle_name": "H",
            "credential": "M.A. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.