Individual provider Active NPI

Nicholas Quod

  • Speech-Language Pathologist
  • Lake Ronkonkoma, NY
National Provider Identifier
1336757251
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
51 School St
Lake Ronkonkoma, NY 11779-2298
Phone
(631) 471-1300
NPI assigned
Jul 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 Primary

Addresses

Primary practice location

51 School St
Lake Ronkonkoma, NY 11779-2298

Mailing address

19 Country Greens CT
West Islip, NY 11795-2335
Phone (631) 893-6574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719002476 NY Practitioner - Qualified Speech Language Pathologist 1850837329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theralympic Speech Therapy PLLC Speech-Language Pathologist CurrentSince May 12, 2024 Accepting new patients
Andrea E Nomberg Physician PC CurrentSince May 12, 2024 Accepting new patients

Locations

400 S Oyster Bay Rd
Ste 102
Hicksville, NY 11801
Phone (516) 595-7550

2330 Union Blvd
Islip, NY 11751
Phone (631) 224-4200

622 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 240-3579

624 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 240-3579

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1336757251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 COUNTRY GREENS CT",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952335",
            "telephone_number": "631-893-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SCHOOL ST",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792298",
            "telephone_number": "631-471-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUOD",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.