Individual provider Active NPI

Ida Barresi, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1114058054
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
007411 Issued in NY
Practice address
1225 Morris Park Ave
Bronx, NY 10461-1949
Phone
(718) 839-7153
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 007411 NY Primary

Addresses

Primary practice location

1225 Morris Park Ave
Bronx, NY 10461-1949

Mailing address

65 Roosevelt Dr
Bedford Hills, NY 10507-1013
Phone (914) 666-4501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121001078 NY Practitioner - Qualified Speech Language Pathologist 7214216977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 24, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Sep 24, 2016 Accepting new patients

Locations

1165 Morris Park Ave
Bronx, NY 10461
Phone (718) 430-3900

1225 Morris Park Ave
Bronx, NY 10461
Phone (718) 430-8500

1621 Eastchester Rd
Bronx, NY 10461

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1114058054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ROOSEVELT DR",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071013",
            "telephone_number": "914-666-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611949",
            "telephone_number": "718-839-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRESI",
        "first_name": "IDA",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "007411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.