Individual provider Active NPI

Monica R Fernandez-Ebert, M.A. CCC-SLP TSSLD

  • Speech-Language Pathologist
  • Peekskill, NY
National Provider Identifier
1417474206
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
029133 Issued in NY
Practice address
115 High St
Peekskill, NY 10566-2809
Phone
(917) 912-6590
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 029133 NY Primary

Addresses

Primary practice location

115 High St
Peekskill, NY 10566-2809

Mailing address

115 High St
Peekskill, NY 10566-2809
Phone (917) 912-6590

Other practice location 1

2700 Westchester Ave Ste 300
Purchase, NY 10577
Phone (914) 328-2868

Other practice location 2

1997 Route 17M Ste 9
Goshen, NY 10924-5233
Phone (845) 294-4787

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

LicenseStateTypeSpecialty
029133NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Isaac'S Friends, Inc. Speech-Language Pathologist CurrentSince Sep 25, 2022 Accepting new patients
Teshonnell Inc. PastSince Sep 25, 2019 Accepting new patients
Communication Station, LLP. Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 3

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1417474206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HIGH ST",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662809",
            "telephone_number": "917-912-6590",
            "fax_number": "914-328-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HIGH ST",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662809",
            "telephone_number": "917-912-6590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Westchester Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Purchase",
            "state": "NY",
            "postal_code": "10577",
            "country_code": "US",
            "telephone_number": "914-328-2868",
            "fax_number": "914-328-2973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Route 17M Ste 9",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "NY",
            "postal_code": "109245233",
            "country_code": "US",
            "telephone_number": "845-294-4787",
            "fax_number": "845-294-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ-EBERT",
        "first_name": "MONICA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peekskill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.