Individual provider Active NPI

Diana Lynn Pasiecznik, MA CCC-SLP

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1164949772
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
023322-1 Issued in NY
Practice address
85 Elmwood Park Dr Apt 36
Staten Island, NY 10314-7519
Phone
(718) 541-2000
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 023322-1 NY Primary

Addresses

Primary practice location

85 Elmwood Park Dr Apt 36
Staten Island, NY 10314-7519

Mailing address

85 Elmwood Park Dr Apt 36
Staten Island, NY 10314-7519
Phone (718) 541-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171127002371 NY Practitioner - Qualified Speech Language Pathologist 3678830833 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023322-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Speech-Language Pathologist CurrentSince Dec 18, 2017 Accepting new patients
Affinity Rehabilitation LLP CurrentSince Oct 3, 2017 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164949772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 ELMWOOD PARK DR APT 36",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147519",
            "telephone_number": "718-541-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 ELMWOOD PARK DR APT 36",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147519",
            "telephone_number": "718-541-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASIECZNIK",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "023322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.