Individual provider Active NPI

Melinda L Ackley

  • Speech-Language Pathologist
  • Elma, NY
National Provider Identifier
1164564845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
013362-1 Issued in NY
Practice address
960 Maple Rd
Suburban Adult Services
Elma, NY 14059-9530
Phone
(716) 805-1555
Fax
(716) 805-1444
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 013362-1 NY Primary

Addresses

Primary practice location

960 Maple Rd
Suburban Adult Services
Elma, NY 14059-9530

Mailing address

11399 Springville Boston Rd
East Concord, NY 14055-9711
Phone (716) 592-4247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109000424 NY Practitioner - Qualified Speech Language Pathologist 5991064412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Adult Services Inc.Group PAC ID 1658378583, 14 clinicians

Practice addresses (Care Compare)

960 W Maple CT
Elma, NY 14059-9397
Phone (716) 805-1440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013362NYMDChiropractor
013362-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Adult Services-Inc. CurrentSince Nov 4, 2017 Accepting new patients

Locations

960 W Maple Ct
Elma, NY 14059
Phone (716) 805-1440

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164564845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11399 SPRINGVILLE BOSTON RD",
            "city": "EAST CONCORD",
            "state": "NY",
            "postal_code": "140559711",
            "telephone_number": "716-592-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 MAPLE RD",
            "address_2": "SUBURBAN ADULT SERVICES",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140599530",
            "telephone_number": "716-805-1555",
            "fax_number": "716-805-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKLEY",
        "first_name": "MELINDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013362-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.