Active NPI
Susan Laks, MSSLPPPC
- Speech-Language Pathologist
- New York, NY
National Provider Identifier
1265672091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0112201
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12016339 | Other | NY | ASHA |
| 0112201 | Other | NY | NEW YORK STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0112201 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hamaspik of Kings County, Inc. | Current | Accepting new patients | |
| Hamaspik of Kings County | Current | 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.
-
- Case Management Agency
- Brooklyn, NY
- NPI 1700120888
-
- Developmental Disabilities Clinic/Center
- Brooklyn, NY
- NPI 1730859976
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.