Individual provider Active NPI

Jessica Melissa Baquero

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1194962290
Registry record updated Jan 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
465 Grand St
#2
New York, NY 10002-4800
Phone
(212) 420-1999
NPI assigned
Jan 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2009

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 Primary

Addresses

Primary practice location

465 Grand St
#2
New York, NY 10002-4800

Mailing address

7906 35TH Ave
#1R
Jackson Heights, NY 11372-2742
Phone (917) 637-0271

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019557NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1231632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231632000000",
    "number": "1194962290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7906 35TH AVE",
            "address_2": "#1R",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722742",
            "telephone_number": "917-637-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 GRAND ST",
            "address_2": "#2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024800",
            "telephone_number": "212-420-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAQUERO",
        "first_name": "JESSICA",
        "middle_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-11",
        "last_updated": "2009-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "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 Jan 11, 2009; 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.