Individual provider Active NPI

Jaclyn Lucey, SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1205393857
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15548 Issued in FL
Practice address
3280 Progress Dr Ste 500
Orlando, FL 32826-2903
Phone
(407) 882-0468
NPI assigned
Mar 1, 2019
Last updated
Mar 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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 SA15548 FL Primary

Addresses

Primary practice location

3280 Progress Dr Ste 500
Orlando, FL 32826-2903

Mailing address

3280 Progress Dr Ste 500
Orlando, FL 32826-2903
Phone (407) 882-0468

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912004478 FL Practitioner - Qualified Speech Language Pathologist 7315487691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3280 Progress Dr
Suite 500
Orlando, FL 32826-2903
Phone (407) 882-0468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA15548FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Central Florida Board of Trustees Speech-Language Pathologist Current Accepting new patients
The University of Central Florida Board of Trustees CurrentSince Sep 6, 2024 Accepting new patients

Locations

3280 Progress Dr
Ste 500
Orlando, FL 32826
Phone (407) 882-0468

3400 Quadrangle Blvd
Orlando, FL 32817
Phone (407) 266-3627

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1205393857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 PROGRESS DR STE 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328262903",
            "telephone_number": "407-882-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 PROGRESS DR STE 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328262903",
            "telephone_number": "407-882-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCEY",
        "first_name": "JACLYN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.