Individual provider Active NPI

Laura Melissa Glass, SLP

  • Speech-Language Pathologist
  • Farmingdale, NY
National Provider Identifier
1154760189
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1415942 Issued in NY
Practice address
399 Conklin St
Suite 303
Farmingdale, NY 11735-2614
Phone
(516) 249-5477
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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 1415942 NY Primary

Addresses

Primary practice location

399 Conklin St
Suite 303
Farmingdale, NY 11735-2614

Mailing address

31 Azalea Dr
Syosset, NY 11791-2804
Phone (516) 587-7006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140421001273 NY Practitioner - Qualified Speech Language Pathologist 8325270606 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023313NYMDPhysical Therapist
1415942NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation Current Accepting new patients
Nassau Health Care Corporation CurrentSince Nov 6, 2018 Accepting new patients
Nassau Health Care Corporation CurrentSince Nov 6, 2018 Accepting new patients
Allied Speech-Language Therapy, P.C. Past Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

2201 Hempstead Tpke
Fl 19
East Meadow, NY 11554
Phone (516) 486-6862

Organizations & group practices 4

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1154760189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 AZALEA DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117912804",
            "telephone_number": "516-587-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 CONKLIN ST",
            "address_2": "SUITE 303",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352614",
            "telephone_number": "516-249-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "LAURA",
        "middle_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1415942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.