Individual provider Active NPI

Jenyne Damiano

  • Speech-Language Pathologist
  • Belmar, NJ
National Provider Identifier
1437550308
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00620800 Issued in NJ
Practice address
508 10TH Ave
Belmar, NJ 07719-2317
Phone
(732) 910-9196
Fax
(732) 894-3475
NPI assigned
Sep 10, 2014
Last updated
Sep 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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 41YS00620800 NJ Primary

Addresses

Primary practice location

508 10TH Ave
Belmar, NJ 07719-2317

Mailing address

508 10TH Ave
Belmar, NJ 07719-2317
Phone (732) 910-9196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141111002107 NJ Practitioner - Qualified Speech Language Pathologist 7416179213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Home Rehabilitation, LLCGroup PAC ID 0345418646, 50 clinicians

Practice addresses (Care Compare)

508 10TH Ave
Belmar, NJ 07719-2317
Phone (908) 670-6695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YS00620800NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Home Rehabilitation, LLC CurrentSince Sep 11, 2014 Accepting new patients

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, 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": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1437550308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 10TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192317",
            "telephone_number": "732-910-9196",
            "fax_number": "732-894-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 10TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192317",
            "telephone_number": "732-910-9196",
            "fax_number": "732-894-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIANO",
        "first_name": "JENYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00620800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmar, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.