Individual provider Active NPI

Deborah Ann Bryden, HEARING CONSULTANT

  • Speech-Language Pathologist
  • Auburn, NY
National Provider Identifier
1376751065
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003886 Issued in NY
Practice address
3074 E Genesee Street Rd
Auburn, NY 13021-4356
Phone
(315) 252-6863
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X NY
Speech-Language Pathologist 235Z00000X 003886 NY Primary

Addresses

Primary practice location

3074 E Genesee Street Rd
Auburn, NY 13021-4356

Mailing address

3074 E Genesee Street Rd
Auburn, NY 13021-4356
Phone (315) 252-6863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000917 NY Practitioner - Qualified Speech Language Pathologist 7416136478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seneca Cayuga Counties Chapter Nysarc, Inc.Group PAC ID 3476653015, 12 clinicians

Practice addresses (Care Compare)

1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202
Phone (315) 856-8257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Cayuga Counties Chapter Nysarc, Inc. CurrentSince Jul 14, 2010 Accepting new patients

Locations

1521 Clark Street Rd
Auburn, NY 13021
Phone (315) 253-7331

1083 Waterloo Geneva Rd
Waterloo, NY 13165
Phone (315) 539-4049

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1376751065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 E GENESEE STREET RD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214356",
            "telephone_number": "315-252-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 E GENESEE STREET RD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214356",
            "telephone_number": "315-252-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYDEN",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "HEARING CONSULTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "003886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.