Individual provider Active NPI

Joan Gavitt Cumisky

  • Speech-Language Pathologist
  • Massapequa, NY
National Provider Identifier
1356628465
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004367-1 Issued in NY
Practice address
190 East Shore Dr
Massapequa, NY 11758
Phone
(516) 795-8854
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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 004367-1 NY Primary

Addresses

Primary practice location

190 East Shore Dr
Massapequa, NY 11758

Mailing address

190 E Shore Dr
Massapequa, NY 11758-7612
Phone (516) 795-8854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004367-1NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1356628465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E SHORE DR",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587612",
            "telephone_number": "516-795-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 EAST SHORE DR",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-795-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMISKY",
        "first_name": "JOAN",
        "middle_name": "GAVITT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004367-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.