Individual provider Active NPI

Miriam M Pratt, M.S.

  • Speech-Language Pathologist
  • Staten Island, NY
National Provider Identifier
1326266206
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005597-1 Issued in NY
Practice address
657 Castleton Avenue
Staten Island, NY 10301
Phone
(718) 448-9775
Fax
(718) 448-6072
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005597-1 NY Primary

Addresses

Primary practice location

657 Castleton Avenue
Staten Island, NY 10301

Mailing address

178 Morrison Ave
Staten Island, NY 10310-2835
Phone (718) 442-3646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090810000008 NY Practitioner - Qualified Speech Language Pathologist 7012060072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005597-1NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Clinical Care PLLC CurrentSince Jan 18, 2005 Accepting new patients
Lifespire, Inc. Past Accepting new patients
Lifespire, Inc. Past Accepting new patients
Superior Clinical Care PLLC PastSince Apr 1, 2016 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326266206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 MORRISON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102835",
            "telephone_number": "718-442-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 CASTLETON AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-448-9775",
            "fax_number": "718-448-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "MIRIAM",
        "middle_name": "M",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005597-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.