Active NPI
Michelle Cervantes, M.A.
- Speech-Language Pathologist
- Astoria, NY
National Provider Identifier
1417332867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 026024
- Practice address
- 3015 29TH St
Astoria, NY 11102-2502 - Phone
- (718) 956-2760
- NPI assigned
- Jul 28, 2015
- Last updated
- Dec 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 026024 | NY | Primary |
Addresses
Primary practice location
3015 29TH St
Astoria, NY 11102-2502
Mailing address
3039 69TH St
Woodside, NY 11377-1231
Phone (646) 285-6545
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026024 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1417332867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3039 69TH ST",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113771231",
"telephone_number": "646-285-6545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 29TH ST",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111022502",
"telephone_number": "718-956-2760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERVANTES",
"first_name": "MICHELLE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-28",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "026024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.