Individual provider Active NPI

Nicole Ann Fiscella, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Lynbrook, NY
National Provider Identifier
1215726245
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
033742-01 Issued in NY
Practice address
100 Peninsula Blvd
Lynbrook, NY 11563-3250
Phone
(516) 596-2700
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 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 033742-01 NY Primary

Addresses

Primary practice location

100 Peninsula Blvd
Lynbrook, NY 11563-3250

Mailing address

335 Grange St
Franklin Square, NY 11010-3401
Phone (516) 538-1386

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509002638 NY Practitioner - Qualified Speech Language Pathologist 0941727168

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033742-01NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Onr National Speech Pathology Inc CurrentSince May 1, 2025 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

100 Peninsula Blvd
Lynbrook, NY 11563
Phone (516) 596-2700

Organizations & group practices 1

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": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1215726245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 GRANGE ST",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110103401",
            "telephone_number": "516-538-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PENINSULA BLVD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633250",
            "telephone_number": "516-596-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCELLA",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033742-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.