Individual provider Active NPI

Ana Perez

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1205111226
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020614-1 Issued in NY
Practice address
92 Van Cortlandt Park S
#6C
Bronx, NY 10463-2922
Phone
(646) 387-5656
NPI assigned
Oct 21, 2011
Last updated
Oct 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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 020614-1 NY Primary

Addresses

Primary practice location

92 Van Cortlandt Park S
#6C
Bronx, NY 10463-2922

Mailing address

92 Van Cortlandt Park S
#6C
Bronx, NY 10463-2922
Phone (646) 387-5656

Other identifiers 1

IdentifierTypeStateIssuer
658026061OtherNYTSSLD LICENCE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020614-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1205111226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 VAN CORTLANDT PARK S",
            "address_2": "#6C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632922",
            "telephone_number": "646-387-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 VAN CORTLANDT PARK S",
            "address_2": "#6C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104632922",
            "telephone_number": "646-387-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020614-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSSLD LICENCE",
            "identifier": "658026061",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.