Kristina L Carraccia, MS, CCC-SLP, TSSLD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

58-019606 Issued in NY

Practice address

606 Old Route 17
Monticello, NY 12701-7013

Phone

(845) 707-8400

Fax

(845) 707-8916

NPI assigned

Oct 4, 2010

Last updated

Jun 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristina L Mootz Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• The Center for Discovery Inc

  • Rural Health Clinic/Center
  • Monticello, NY
  • NPI 1275624694
  Medicare reassignment NPD
• The Center for Discovery Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Rock Hill, NY
  • NPI 1669202610
  NPD
• Babies & Beyond, SLP, PT, OT, PLLC

  • Early Intervention Provider Agency
  • Monticello, NY
  • NPI 1386951754
  NPD (past)

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1306155619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MCGUIRE RD",
            "city": "WOODBOURNE",
            "state": "NY",
            "postal_code": "127885456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 OLD ROUTE 17",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127017013",
            "telephone_number": "845-707-8400",
            "fax_number": "845-707-8916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "544 Broadway Ste 3",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127011175",
            "country_code": "US",
            "telephone_number": "845-794-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRACCIA",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "credential": "MS, CCC-SLP, TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019606-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "58-019606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "019606-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MOOTZ",
            "middle_name": "L",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William J Burretto, P.T.
• Ervin Burros, PH.D.
• Angella Burton, RN
• Mihai Busuioc, OD
• Sarah J Butto, OTR/L
• Elizabeth Carrasquillo, LMSW
• Jacqueline Carrasquillo
• Rebecca Ilyse Cartmill
• Nicole M Casamassima
• Rodrick Cash Sr.

• Speech-Language Pathologist in Monticello, NY
• Providers in Monticello, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.