Individual provider Active NPI

Tasanyia K Sebro-Calderon, M.S., CCC- SLP/TSLD

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1184924185
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
019687-1 Issued in NY
Practice address
227 E 86TH St
Brooklyn, NY 11236-1401
Phone
(917) 575-6138
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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 019687-1 NY Primary

Addresses

Primary practice location

227 E 86TH St
Brooklyn, NY 11236-1401

Mailing address

227 E 86TH St
Brooklyn, NY 11236-1401
Phone (917) 575-6138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718000617 NY Practitioner - Qualified Speech Language Pathologist 8426328808 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019687-1NYMDSpeech-Language Pathologist

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1184924185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361401",
            "telephone_number": "917-575-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361401",
            "telephone_number": "917-575-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBRO-CALDERON",
        "first_name": "TASANYIA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC- SLP/TSLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019687-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.