Individual provider Active NPI

Kimberly Anne Ricigliano, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Canandaigua, NY
National Provider Identifier
1336206903
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
014165-1 Issued in NY
Practice address
5415 N Bloomfield Rd
Canandaigua, NY 14424-7964
Phone
(585) 394-9510
NPI assigned
Jan 3, 2007
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 014165-1 NY Primary

Addresses

Primary practice location

5415 N Bloomfield Rd
Canandaigua, NY 14424-7964

Mailing address

27 Little Briggins Cir
Fairport, NY 14450-9723
Phone (585) 425-1869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806000173 NY Practitioner - Qualified Speech Language Pathologist 1153868302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Voiceover Speech Pathology Services, PLLCGroup PAC ID 9335581990, 3 clinicians

Practice addresses (Care Compare)

3177 Latta Rd
Suite 217
Rochester, NY 14612-3094
Phone (585) 365-4633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014165NYMDMental Health Counselor
014165-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Voiceover Speech Pathology Services, PLLC Speech-Language Pathologist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3177 Latta Rd
Ste 217
Rochester, NY 14612
Phone (585) 365-4633

Organizations & group practices 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336206903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 LITTLE BRIGGINS CIR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509723",
            "telephone_number": "585-425-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 N BLOOMFIELD RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICIGLIANO",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014165-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, 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.
  • 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.