Individual provider Active NPI

Michael Oliveira, CCC-SLP

  • Speech-Language Pathologist
  • Anchorage, AK
National Provider Identifier
1093399263
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
177255 Issued in AK
Practice address
6311 Debarr Rd Ste J
Anchorage, AK 99504-1777
Phone
(907) 231-6268
NPI assigned
May 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 177255 AK Primary

Addresses

Primary practice location

6311 Debarr Rd Ste J
Anchorage, AK 99504-1777

Mailing address

2440 E Tudor Rd # 338
Anchorage, AK 99507-1185

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

State licenses

LicenseStateTypeSpecialty
177255AKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gift of Gab Speech Therapy, LLC Speech-Language Pathologist Current 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": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1093399263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E TUDOR RD # 338",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 DEBARR RD STE J",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995041777",
            "telephone_number": "907-231-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEIRA",
        "first_name": "MICHAEL",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "177255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.