Individual provider Active NPI

Jessica Danielle Reiss, MS, CCC-SLP

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1245484435
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
018189-1 Issued in NY
Practice address
292 Madison Ave
2ND Floor
New York, NY 10017-6307
Phone
(212) 420-0510
NPI assigned
Nov 14, 2008
Last updated
Sep 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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 018189-1 NY Primary

Addresses

Primary practice location

292 Madison Ave
2ND Floor
New York, NY 10017-6307

Mailing address

155 Washington St
Apt 1005
Jersey City, NJ 07302-4572
Phone (732) 236-2995

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
018189-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1245484435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WASHINGTON ST",
            "address_2": "APT 1005",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024572",
            "telephone_number": "732-236-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 MADISON AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176307",
            "telephone_number": "212-420-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "name_prefix": "Miss",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018189-1",
            "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 Sep 11, 2012; 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.