Individual provider Active NPI

Irina Ostrovskaya, M.S., CCC-SLP

  • Speech-Language Pathologist
  • North Andover, MA
National Provider Identifier
1114387578
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
76783 Issued in MA
Practice address
790 Turnpike St Ste 105
North Andover, MA 01845-6129
Phone
(508) 478-0207
Fax
(508) 634-6984
NPI assigned
Feb 29, 2016
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 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 76783 MA Primary

Addresses

Primary practice location

790 Turnpike St Ste 105
North Andover, MA 01845-6129

Mailing address

321 Fortune Blvd Ste 202
Milford, MA 01757-1750
Phone (508) 478-0207

Other identifiers 2

IdentifierTypeStateIssuer
14133323OtherAMERICAN SPEECH HEARING ASSOCIATION - CERTIFICATE OF CLINICAL COMPETENCE
76783OtherMASPEECH-LANGUAGE PATHOLOGIST

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 Science

State licenses

LicenseStateTypeSpecialty
76783MAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1114387578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FORTUNE BLVD STE 202",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571750",
            "telephone_number": "508-478-0207",
            "fax_number": "508-684-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 TURNPIKE ST STE 105",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456129",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROVSKAYA",
        "first_name": "IRINA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "76783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH HEARING ASSOCIATION - CERTIFICATE OF CLINICAL COMPETENCE",
            "identifier": "14133323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST",
            "identifier": "76783",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

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