Individual provider Active NPI

Hannah Tahhan-Jackson, M.S., CCC-SLP, BCS-S

  • Speech-Language Pathologist
  • Amawalk, NY
National Provider Identifier
1215351374
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2573121 Issued in NY
Practice address
10 Pinesbridge Rd
Amawalk, NY 10501-1300
Phone
(914) 417-1755
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X
Speech-Language Pathologist 235Z00000X 2573121 NY Primary

Addresses

Primary practice location

10 Pinesbridge Rd
Amawalk, NY 10501-1300

Mailing address

10 Pinesbridge Rd
Amawalk, NY 10501-1300

Other practice location 1

2877 Mead St
Yorktown Heights, NY 10598-2705
Phone (914) 417-1755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200323001279 NY Practitioner - Other (Non-Physician) 4082042270 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2573121NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Feb 17, 2020 Accepting new patients
Boston Children'S Health Physicians, LLP CurrentSince Feb 17, 2020 Accepting new patients
Evolve SLP Therapy Services PLLC Lactation Consultant, Non-RN CurrentSince Jan 28, 2024 Accepting new patients

Locations

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

40 Sunshine Cottage Rd
Valhalla, NY 10595
Phone (914) 594-2200

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

Networks

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

Interoperability endpoints

  • 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": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1215351374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PINESBRIDGE RD",
            "city": "AMAWALK",
            "state": "NY",
            "postal_code": "105011300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PINESBRIDGE RD",
            "city": "AMAWALK",
            "state": "NY",
            "postal_code": "105011300",
            "telephone_number": "914-417-1755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2877 Mead St",
            "address_purpose": "LOCATION",
            "city": "Yorktown Heights",
            "state": "NY",
            "postal_code": "105982705",
            "country_code": "US",
            "telephone_number": "914-417-1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAHHAN-JACKSON",
        "first_name": "HANNAH",
        "credential": "M.S., CCC-SLP, BCS-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "2573121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amawalk, NY

Sources for this page

Verify at the official NPI Registry.