Individual provider Active NPI

Macie Wasserberger

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1164113346
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
033056-01 Issued in NY
Practice address
303 W 21St St Apt 8G
New York, NY 10011-3085
Phone
(914) 815-3850
NPI assigned
May 17, 2023
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 033056-01 NY Primary

Addresses

Primary practice location

303 W 21St St Apt 8G
New York, NY 10011-3085

Mailing address

303 W 21St St Apt 8G
New York, NY 10011-3085
Phone (914) 815-3850

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
033056-01NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1164113346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W 21ST ST APT 8G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100113085",
            "telephone_number": "914-815-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W 21ST ST APT 8G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100113085",
            "telephone_number": "914-815-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERBERGER",
        "first_name": "MACIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033056-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.