Individual provider Active NPI

Anastasiya Lysenko

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1194582817
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
035509 Issued in NY
Practice address
44 Court St Ste 1217
Brooklyn, NY 11201-4410
Phone
(347) 479-1868
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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 035509 NY Primary

Addresses

Primary practice location

44 Court St Ste 1217
Brooklyn, NY 11201-4410

Mailing address

23 Old Mamaroneck Rd Apt 4G
White Plains, NY 10605-2016
Phone (518) 810-1419

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828003712 NY Practitioner - Qualified Speech Language Pathologist 6800397118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
New York Medical College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Children'S Health Physicians LLPGroup PAC ID 8325937014, 80 clinicians

Practice addresses (Care Compare)

30 Plaza W
Children'S and Women'S Physicians of
Valhalla, NY 10595-1572
Phone (914) 594-4914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
035509NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Aug 1, 2025 Accepting new patients
Boston Children'S Health Physicians, LLP CurrentSince Aug 1, 2025 Accepting new patients
Pomona Pediatrics PC Past Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (314) 400-4416

30 Plaza W
Valhalla, NY 10595
Phone (914) 594-4912

30 Plaza W
Rm 213
Valhalla, NY 10595

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: anastasiya.lysenko.p1@direct.cwpw.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1194582817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 OLD MAMARONECK RD APT 4G",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052016",
            "telephone_number": "518-810-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COURT ST STE 1217",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014410",
            "telephone_number": "347-479-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSENKO",
        "first_name": "ANASTASIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "035509",
            "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 Jun 12, 2025; 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.