Individual provider Active NPI

Susan Laks, MSSLPPPC

  • Speech-Language Pathologist
  • New York, NY
National Provider Identifier
1265672091
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0112201 Issued in NY
Practice address
453 FDR Dr
New York, NY 10002-5952
Phone
(917) 869-3758
NPI assigned
Mar 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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 0112201 NY Primary

Addresses

Primary practice location

453 FDR Dr
New York, NY 10002-5952

Mailing address

453 FDR Dr
New York, NY 10002-5952
Phone (917) 869-3758

Other identifiers 2

IdentifierTypeStateIssuer
12016339OtherNYASHA
0112201OtherNYNEW YORK STATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614001319 NY Practitioner - Qualified Speech Language Pathologist 6406214030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
City University of New York School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamaspik of Kings County, Inc.Group PAC ID 8628472768, 18 clinicians

Practice addresses (Care Compare)

4102 13TH Ave
Brooklyn, NY 11219-1389
Phone 7184008899106

4102 14TH Ave
Brooklyn, NY 11219-1401
Phone (718) 387-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0112201NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamaspik of Kings County, Inc. CurrentSince May 8, 2023 Accepting new patients
Hamaspik of Kings County CurrentSince May 8, 2023 Accepting new patients

Locations

4102 14th Ave
Fl 2
Brooklyn, NY 11219
Phone (718) 387-8400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1265672091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 FDR DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025952",
            "telephone_number": "917-869-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 FDR DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025952",
            "telephone_number": "917-869-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKS",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MSSLPPPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0112201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "12016339",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "0112201",
            "state": "NY"
        }
    ],
    "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 Mar 6, 2009; 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.