Individual provider Active NPI

Heather Fazio

  • Speech-Language Pathologist
  • Brookline, MA
National Provider Identifier
1245923036
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
68 Harvard St
Brookline, MA 02445-7991
Phone
(888) 828-4114
NPI assigned
May 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 Primary

Addresses

Primary practice location

68 Harvard St
Brookline, MA 02445-7991

Mailing address

40 Fleet St
Boston, MA 02109-1143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926001892 NY Practitioner - Qualified Speech Language Pathologist 1759886062 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

172 Ave B
Holbrook, NY 11741-1403

622 Hawkins Ave
Ronkonkoma, NY 11779-2399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea E Nomberg Physician PC CurrentSince Sep 1, 2025 Accepting new patients
Zebra Speech Speech-Language Pathologist CurrentSince Mar 17, 2024 Accepting new patients
Theralympic Speech Therapy PLLC Speech-Language Pathologist CurrentSince Sep 1, 2025 Accepting new patients

Locations

68 Harvard St
Brookline, MA 02445
Phone (617) 487-4345

622 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 240-3579

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1245923036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FLEET ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457991",
            "telephone_number": "888-828-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.