Individual provider Active NPI

Nilsa Rubin-Perez, SLP, CCC, TSSH

  • Speech-Language Pathologist
  • Bronx, NY
National Provider Identifier
1396956470
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3467-1 Issued in NY
Practice address
2214 Kingsland Ave
Bronx, NY 10469-6411
Phone
(718) 515-4596
NPI assigned
May 24, 2007
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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 3467-1 NY Primary

Addresses

Primary practice location

2214 Kingsland Ave
Bronx, NY 10469-6411

Mailing address

2214 Kingsland Ave
Bronx, NY 10469-6411
Phone (718) 515-4596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161014000915 NY Practitioner - Qualified Speech Language Pathologist 9234427840 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3467-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC Speech-Language Pathologist CurrentSince Jan 1, 2021 Accepting new patients
East Post Road Medical Services PC CurrentSince Jan 1, 2021 Accepting new patients

Locations

99 Business Park Dr
Armonk, NY 10504
Phone (914) 219-8515

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1396956470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 KINGSLAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696411",
            "telephone_number": "718-515-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 KINGSLAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696411",
            "telephone_number": "718-515-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN-PEREZ",
        "first_name": "NILSA",
        "credential": "SLP, CCC, TSSH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "3467-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.