Active NPI
Kimberly A. Zajac, CCC-SLP/A
- Speech-Language Pathologist
- Quincy, MA
National Provider Identifier
1093785073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4685
- Practice address
- 1250 Hancock St
Quincy, MA 02169-4339 - Phone
- (617) 774-0750
- NPI assigned
- Jan 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4685 | MA | Primary |
| Audiologist | 231H00000X | 605 | MA |
Addresses
Primary practice location
1250 Hancock St
Quincy, MA 02169-4339
Mailing address
1250 Hancock St
Quincy, MA 02169-4339
Phone (617) 774-0750
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0310191 | Medicaid | MA | |
| 7542869 | Other | AETNA | |
| PJ198 | Other | MA | HARVARD PILGRIM |
| 0014867 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 1093785073 | Other | FALLON COMMUNITY HEALTH PLAN | |
| SP0085 | Other | MA | BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 605 | MA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254700800000",
"number": "1093785073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 HANCOCK ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694339",
"telephone_number": "617-774-0750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 HANCOCK ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694339",
"telephone_number": "617-774-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAJAC",
"first_name": "KIMBERLY",
"middle_name": "A.",
"credential": "CCC-SLP/A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-24",
"last_updated": "2009-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "4685",
"primary": true
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MA",
"license": "605",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0310191",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7542869",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "PJ198",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0014867",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH PLAN",
"identifier": "1093785073",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "SP0085",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.